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The value of understanding and using metrics for dental hygienists

March 11, 2021
Talking practice metrics can make hygienists, who want to do the best by their patients, defensive and argumentative. But are metrics and patient health really so opposed?

Are you a dental hygienist who cringes anytime the topics of production numbers or office metrics are mentioned? As hygienists, we’re told that knowledge is power, which we generally embrace—until metrics are mentioned. Then we often become defensive and sometimes even argumentative. It’s not unusual for our fellow hygienists to say things like “I’m treating my patients and doing the right thing,” “I don’t care about the numbers,” or “That doesn't concern me. I treat the patient in the chair.”

But the truth is that having an awareness of your office metrics and providing quality patient care are more connected than you may think. Being aware of your metrics

  • allows you to engage and contribute to team culture and goal-setting;
  • decreases differences between services recommended and provided;
  • helps identify areas that need focus (along with areas of success and celebration); 
  • positions you with the ability to have a positive impact on comprehensive patient care and shows you the change in your service mix; and
  •  provides talking points for future compensation discussions.

The key is that by doing what’s good for the patient, you’ll automatically have a positive impact on the metrics of your office. Doctors and office managers—please don’t shy away from sharing metrics. In fact, sharing important information about patient care along with the business side of the practice and profitability can help synergize your team and build focus on providing comprehensive patient care while building office efficiencies. For hygienists, learning to understand and embrace the metrics and builds both skills and business acumen to show increased value to the practice.

Establish goals

How do you know where you’re going if you don’t know where you are now? It’s so important to know how the office is doing. Are you aligned when it comes to topics like caries risk prevention, periodontal classification, and comprehensive patient care that positively impacts disease? Often in early discussions with an office on their periodontal/prophy ratios, percentages are frequently weighted to be significantly prophy based. This could be for a variety of reasons: we may be providing the care and not coding it out accurately, we may not have a documented periodontal protocol in place for clarity as to when patients need to transition into periodontal treatment, or we may not be consistent with performing our assessments. Whatever the reason, we know that prevalence of periodontal disease in adults indicates that far more patients are not in a state of health—leaving us to wonder why so many receive a prophylaxis, and why the percentage of perio procedures isn’t higher. Increasing the focus on diagnosis and treatment of periodontal disease will result in an increase in your perio mix of services and would align with many clinicians’ desire to positively impact patients’ health while simultaneously having a positive impact on office success.

Keep in mind that not all metrics are tied to a specific patient service but still have a positive impact on your office’s success—for example, recall and retention rates. If office recall is trending at 80%, what are the schedules going to look like in three, four, and six months from now? They could be pretty empty, and once we have open schedules, what do we do? Do we merge schedules or are you asked to make calls to attempt to recapture patients? Neither option is great; our heart tends to lie in patient care and treatment outcomes, not administrative tasks. The compounded effect of an opening in hygiene today means an opening on the restorative side tomorrow. These openings escalate quickly. A good office goal could be to get the recall percent above 95%—now everyone is working to have a positive impact on getting the patient scheduled for a future visit while keeping the office productive.

Differentiate feelings and facts

What we feel we’re providing our patients isn’t always the reality of what we’re doing. Clinicians can feel that they discuss a service or product to all their patients, but when we dive into the fact side of their mix of services, we might find that it doesn’t always result in actual acceptance. Focusing on this fact side may alert providers for the need to change their verbiage or treatment plan presentation approach.

I remember early on in my career when the doctor wanted to implement a caries risk protocol. He requested that we start to position fluoride treatments to any patient with elevated caries risk. Being a prevention specialist, I thought this was a great idea and took the bull by the horns immediately. The doctor came back to me and wanted to discuss the roadblocks I was having to presenting fluoride. I was very confused. My feeling was that I was talking about fluoride to every patient; but the fact was that it wasn’t translating into case acceptance. We worked together to change up verbiage and it immediately increased case acceptance. Had we not reviewed the metrics, I wouldn’t have changed my delivery, and many patients wouldn’t have accepted treatment and received the benefit that fluoride offered them.

Please watch for part two to explore a few more reasons why knowing the office metrics can be a benefit to you as a dental hygienists and how to begin implementation in your office today.

Connie Traynor, BAS, RDH, is a 2003 graduate of the Fox Valley Technical College Dental Hygiene Program and a 2018 graduate of the University of Oshkosh in Leadership/Organizational Studies. Her clinical background includes private, specialty, and group practice. In 2012 she transitioned into a supportive role as a Regional Hygiene Consultant with Midwest Dental where she provides hygiene mentorship and builds doctor/hygiene relations. Please feel to reach out to Connie @[email protected].