Top tips for navigating the pandemic
As a keen sailor, Robbie Lawson considers problems and hurdles as something to be ‘navigated’ by thoughtful planning and consideration, whilst being prepared to alter course if the conditions change unexpectedly along the way
As a lifelong reader of Viz, I appreciate the simplicity of the ‘Top-Tip’ format of simple advice to smooth out life’s dilemmas. Here are my Ten Top-Tips for navigating the COVID-19 pandemic:
# 1: Use the ‘downtime’ productively
Orthodontic practice is busy, time pressured and unrelenting. There is rarely down time for reflection, strategy planning and implementation of new working practices. At Edinburgh Orthodontics, we took the opportunity to move forward with a full restructuring and joined the Portman group, pushing on quickly from embryonic discussions from before the pandemic. We feel that the time involved in discussions, planning and due diligence would have been very challenging to schedule efficiently whilst working at our normal clinical capacity. Other strategy planning was also possible. We were able to get to grips with new practice management software (SfD), consider optimal staff utilisation and plan the route towards a more digital treatment flow.
# 2: Keep the team engaged
The initial lockdown was an unsettling period for the whole team. We had a rotational skeleton staff in the practice, allowing social distancing, dealing with emergency advice and patient communications. We feel that this maintained team integrity and helped reassure our staff that despite the uncertainty of the pandemic, they all had an essential role in contributing to patient care.
# 3: Plan, plan, and plan again for remobilisation
My desktop is littered with SOPs. Webinars and discussions with colleagues allowed constant redrafts of procedures, so that when lockdown ended, we could open safely at the earliest opportunity and in the most efficient manner.
# 4: Engage with the decision makers
At a practice level, conversations with our Dental Practice Advisers and Director of Dentistry allowed more enlightened planning. At a national level, the Scottish Orthodontic Specialists Group worked tirelessly to ensure that orthodontic considerations were not lost in the pandemic chaos, engaging with BDA, SDPC, CDO and Ministers. We took the view that highlighting problems, whilst suggesting solutions with an openness to positive engagement would serve our group best. We remain hopeful that we can help shape the post-pandemic structure of orthodontic care delivery.
# 5: Engage with your peers
The What’s App Ortho Specialist group initiated by Iain Buchanan has been invaluable in sharing thoughts, problems, solutions and offering professional support. It’s also been a great source of tooth-related banter, reducing isolation and keeping spirits up. Simple survey-monkey polls have allowed full group contribution in setting priorities and discussing how best to engage with decision makers.
# 6: Put the patients first
With more than 2,000 patients in active treatment, it was a priority to remobilise as early and efficiently as possible. It has been hard for us, but even harder for the patients who are all worried about their treatment progression. The reduced flow through the practice to allow social distancing has been challenging. We have extended appointment intervals, but despite the uncertainty around the SDR, endeavoured to push cases on towards completion. This has allowed us to see recalls and new patients and commence new cases. Hopefully this patient-centred approach will help cushion the business challenges in the future.
# 7: Ditch the AGPs
To maximise efficiency, we needed to minimise down time. We removed all AGPs from our procedures, introducing self-etching primer, altering protocols to avoid the need for air turbines. Ceramic appliances without fracture risk at debond are preferred (clarity advanced). Quad-helices and palatal arches are removed and replaced with bonded tubes rather than sectioned intra-orally. The micro-etcher is no longer used for lingual bonding.
# 8: Embrace the digital flow
Lockdown has hastened our drive to digital. Aligner cases could be progressed with a Zoom or Facetime with more aligners sent to the patient. Having digital impressions allowed manufacture of replacement retainers without further patient attendance. Scanning has less risk of ‘saliva splatter’ in the surgery. Digital study models allow instant visualisation for communication with patients and have greatly hastened the NHS approval process. Speedy approval has allowed removable appliances to be made without a further impression appointment.
# 9: Reflect
We need to react to ever changing circumstances. We are not doing everything perfectly. Priorities change and processes can be improved. The pandemic has made us step back and appreciate that change is possible, necessary and often positive.
# 10: Keep the heid
It’s been a tough year with limited options to destress from the challenges of navigating the practice through the pandemic. My sailing season was basically cancelled. When rules allowed, surfing and windsurfing proved to be the ideal solo, socially distanced alternatives. Our family were also joined by two kittens, Winnie and Fred. I challenge anyone to feel despondent with a kitten on their lap!
Robbie Lawson is a specialist orthodontist at Edinburgh Orthodontics and was a speaking at the Scottish Orthodontics Conference.