Some circumstances conspire to make it more likely than ever before for an office-based crisis event to occur. Fortunately, there are several things every office can do to prevent, recognize and / or respond to such events.
Patients presenting to today’s dental offices are typically older, arguably less healthy and definitely taking more medications than ever. These circumstances conspire to make it more likely than ever before for an office-based crisis event to occur. Fortunately, there are several things every office can do to prevent, recognize and / or respond to such events.
- Prevention: Every patient should have an updated medical history with an emphasis on recent changes in medical status and medications. A “time out” among staff members should be conducted before beginning treatment and include a review of the planned procedure as well as relevant medical information including allergies. It is important that offices regularly check-on the status of emergency medications and equipment. Finally, all personal should have current certification in Basic Life Support (BLS).
- Recognition: Offices should have on-site concise reference materials that are reviewed as a team on a regular basis. These protocols should include the signs and symptoms of potential crisis events and can be used as quick / real time references in the event of a crisis. The role and responsibility of every staff member should be pre-determined and understood so that they can act as a part of a productive team.
- Response: Given that crisis events are infrequent, there are few opportunities to habituate an effective response. Making this even more challenging is that the stakes of crisis events can be high. Therefore, for our team to perform effectively, we must design and create opportunities for them to acquire and demonstrate the knowledge and skills necessary to successfully deal with a crisis.
In this effort, Crisis Resource Management (CRM) mock drills should be conducted on a regular basis in the effort to prepare every to execute their roles. These drills should provide appropriate challenges, be graduated in difficulty (stretching knowledge and skills, but not too far) and followed by immediate and constructive debriefing. They should be repeated in a manner that reinforces productive actions.
It is important that CRM drills be as realistic and meaningful as possible, emulating the kind of challenges seen in a true emergency. They should involve scenarios with the types of patients the office typically treats and be conducted in a variety of areas of the office (crisis can and do occur in waiting rooms and bathrooms as well as treatment areas).