Are your lab appliances being ordered properly? Are they all arriving at the chair on time for the patient’s appointment? If not, maybe this management pearl can help.
Whether you use an in-house or outside laboratory to make your active auxiliary appliances, plastic aligner appliances and retention appliances, you need a laboratory control system to make sure that they are available at the chair when the patient arrives for their visit.
A laboratory control system requires designated people to make it work. It can be as simple as one lab tech in a one-office practice or it can be as complicated as involving many people in a multi-office practice using in-house and outside labs. But no matter what your situation you will need some variation of the “Lab Log” below to control that system (also see the attached Word file for a customizable copy).
To be effective, your lab control system should flow in the following manner:
1) Ordering the appliance at the chair and scheduling an appointment to have the appliance inserted, while accounting for any extra charges for that appliance.
2) A system for getting the impressions or scans to the lab
3) Control of the manufacturing and delivery of the appliance from your own lab or an outside lab
4) Getting the appliances to the chair on time for the patient’s appointment
We will now apply this chronology to the usual practice situations (doctors and offices), so pick out your situation below and consider how you might utilize that system in your practice.
For a Single-Office, using its in-House Lab:
After taking the impression, scan, etc., (and entering any charges into the computer/etc.), walk it to the lab and log it in: entry #, Patient’s Name, and the Date IN. Ideally, and if possible, your lab tech should do all of the scans, impressions and insertions to totally control your system.
Remember to schedule the Date DUE, 1-3 days before the appointment date to allow for fabrication.
Enter the Date OUT when you place the appliance in your operatory "in-bin" for the patient’s visit.
For a Single-Office practice using an OUTSIDE Lab:
When using an outside lab for fabrication (whether for specific appliances or ALL appliances), the lab tech (or DA) logs in: the Date IN as the day it is shipped (electronically or by snail-mail) and the Date DUE as the date the outside lab must have the finished appliance back to your practice. The Date OUT is the date you placed the finished appliance in the operatory in-bin.
Multi-office, especially with multiple doctors, practices are more complicated than a single office practice. The main difference is that the scans, IMP, etc., should be brought to the main office to be processed and the finished appliances should be brought from the main office to the branch office and stored for the patient’s scheduled visit. It physically requires that each branch office have a: lab log, out-bin (to hold IMP, etc., until transferred to the main office) and an in-bin (to store appliances ready to be inserted). The system is simpler for a multi-office one-doctor practice with just one clinical team then it is for a multi-office multi-doctor practice using multiple clinical teams. It is best if each branch office has a specific DA in charge of all labwork to and from that office.
For a One-Doctor, Multi-Office practice using an in-House Lab:
In a one-doctor practice it is best, if practical, to have one DA (who goes to every office) responsible for controlling the system in that office. You will also need a separate Lab Log in each branch office for control. When processing a patient’s appliance, the branch office Lab Log's Date IN is the day the IMP, etc., was taken back to the main office and the Date DUE is the date the finished appliance needs to be back in the branch office in-bin.
Schedule the appliance insertion appointment far enough ahead of the branch office Lab Log Date DUE to have enough time to fabricate it and transfer it to the branch office in-bin.
The branch office lab log Date OUT is entered when the finished appliance is placed in the branch office in-bin.
For a Multi-Doctor, Multi-Office practice using an in-House Lab:
As much as possible, have a designated DA responsible for controlling all labwork to and from each branch office. Use the branch office Lab Log for control: using the Date IN as the day the IMP, etc., was taken back to the main office and the Date DUE as the date the appliance needs to be back in the branch office in-bin.
Schedule the appliance insertion appointment far enough ahead of the branch office Lab Log Date DUE to have enough time to fabricate it and get it back to the branch office in-bin.
The Date OUT is when the appliance is placed in the branch office in-bin.
For ANY Multi-Office practice using any OUTSIDE Lab:
Process the scan, IMP, etc., the same as above (to get it to and from the main and branch offices).
The lab tech (or designated DA) in the MAIN office logs the scan/IMP Date IN as the day it is shipped (electronically or by snail-mail) to the outside lab and the Date DUE as the date the outside lab must have the finished appliance back to you. The Date OUT is the date you place the finished appliance in your main office in-bin OR the date you sent it to the branch office.
If it is going to the branch office, enter the Date OUT in the branch office Lab Log when placing the appliance in the branch office in-bin.
I hope that this helps you to better control your labwork and get every one of them to the chair on time the patient’s appointment.
