Infection Control Protocol and the Disgruntled Employee

You're listening to the Phil Klein Dental Podcast Dr. Carpenter, it's a pleasure to have you on the show. Phil, thanks for having me. It's good to be back. So we're going to be talking about infection control protocol today and some of the violations that you're familiar with based on the consulting work that you do at Compliance Training Partners. And we'll talk about what your company offers. later on in the show. So we talked offline about a case. We're not going to mention any names, but it involves a dentist. Tell us the story behind this. Tell us the backstory. What's going on with this dentist that is experiencing what I would consider kind of like a nightmare event that's going on in his practice. I'd be glad to talk about it. It's interesting, Phil, because this wasn't exactly what we planned on talking about today, but you and I just happened to be talking about it before we went live here. This just happened last week, and it's really a sad case. I think it's a warning to all of us. A quality dentist, actually a specialist, as a matter of fact, with a quality practice, actually two partners in a practice, who are really doing things quite well. They missed a couple of beats, forgot a couple of little things, and what I'm going to call a fringe. employee in the office, someone who none of us really wants to have in the office, not a quality person. Because, I mean, our staff, what would we do without our staff? We have wonderful staff members in dentistry who help our practice grow. But in this case, this person weaponized it. This has turned into a nightmare for these poor guys in terms of dealing with the state board, dealing with OSHA, threatening their license at risk. I guess the most important take on this is the things we'll talk about today regarding compliance, both infection control and OSHA, they're so important to not only protect our patients and our employees, but to protect our business because we're very vulnerable. So this employee that you're talking about, you know, when they hired this person, they hired this person with goodwill, with the hope of having that person integrate into the practice in a positive way, but it didn't turn out that way. And that happens to all of us. So you're saying that this employee, understood that there were certain violations that were going on in the office and reported that dentist to the state board and outlined what the dentist was doing wrong? Yes, yes, you're correct, Phil. They were reported to both the State Board of Dentistry as well as to OSHA. Unfortunately, they hadn't done a background check on this person. It turns out this employee has been problematic in other offices as well. But it was really something that's very unfortunate. It could happen to any of us if this person walked in our office. We need to be prepared by building an impregnable barrier of compliance. Can you describe what actually the violation was that's being disputed now? Yes, actually a number of things. And remember that OSHA and infection control cross back and forth into one another's territory frequently because OSHA is all about safety for employees. OSHA really doesn't care about our patients. But where infection control plays into OSHA is we want to protect our staff, our dental team, from the threat of infectious disease. Whereas infection control, CDC, our state board, they tend to focus on infection control from the patient perspective. Well, really, a number of violations, some of the key violations I saw, they were missing a couple of safety data sheets. they didn't have a written infection control program. A new employee who hadn't been trained immediately, there was a little bit of time a week or so after hire when they were trained. An employee who left, and that allowed about one week or two weeks where the autoclaves weren't checked, even though all the spore testing before was as it should be, the autoclaves were effective, even though the tests afterwards were excellent. There was a violation. So in other words, they missed a couple of things, written training programs, written documents, training of employees. And to eliminate that, we need to be highly organized. We need to have these documents. We need to have this training. It needs to be part of our protocol. So this is an example of an employee kind of turning on their employer. It's a very sad situation. I know this doctor reached out to you, Dr. Carpenter, as his consultant so that you can help him navigate this issue, which is, as I said earlier in the podcast, is a kind of a nightmare. So are they still doing unannounced inspections in offices? Address that, if you would, and also talk about what triggers an inspection. Well, I will tell you that there aren't that many unannounced inspections. Typically, they give you some warning. a few days, a week. In this case, this was a totally unannounced inspection. Again, a fringe employee contacting the state down board and OSHA who made a surprise inspection. And again, where are we going to get into trouble? Not having training, not having the written programs, not having some simple things like, are you checking your eyewash? once a week, as is required. Do you have a spill kit? Do you have safety data sheets? Not the old MSDS sheets, but the newer type of safety data sheets for every product. Simple, easy to remedy things. Now, do you recommend having one team member held to account in the office? I don't mean to say that in a negative way, but responsible for all of the infection control protocol. that one team member? Or do you recommend distributing that responsibility across multiple employees just in case one staff member has to leave, then you have no one that really knows where anything is regarding the documents and the processes? Well, I will tell you that, first of all, I find it's very important to pick a key employee to be in charge of it. That should be, in the case of ocean infection control, a clinical person. By that, of course, I mean a hygienist. an assistant, somebody who understands the back office. Now, you bring up a good point. We also recommend that they do then have a secondary person, someone who helps assist them. In other words, one person's in charge, one person controls it, but I'd like to have that second clinical person in the office who at least has a rudimentary knowledge for the very reason you say, what if that employee leaves? What if that employee is sick? Now, in the case of HIPAA, and I know we're going to talk about HIPAA another time, For HIPAA, you want to pick someone in charge who is a business office employee, maybe your manager, maybe a quality front desk person. So when you are under an inspection, an inspector comes to your practice, they find some things. You mentioned some of the things that they look for. What is the best way to respond? I will tell you that it's very important that we keep our head about us. We can't get angry. I find that actually most inspectors are quite fair. I actually feel that most of the inspectors, they come in there, they're almost kind of rooting for you, hoping that you have this stuff because they believe in safety. So if you do happen to have a violation, if you forgot a safety data sheet, forgot to train somebody, whatever it might be, I think we need to admit fault. If, in fact, we don't have that, we need to be polite. Treat them just like we would treat our patients. Treat them well. And I find that we can usually go very far doing that, as opposed to many inspections I've been involved with where a doctor gets an angry attorney involved. They try to impede the inspection process. That usually doesn't go well. So the doctor that you're representing, you're not representing because you're not a lawyer, but the doctor that you're consulting for that's undergoing the situation with their employee that's basically kind of turned them into the state board, what is in store for that doctor? What's going on? happen to that practice going forward, and what can you do to help that doctor improve the outcome of the investigation? Well, before I answer that, let me just give you a little background to show you how this can happen. The reason the employee turned in this office, again, this is a quality doctor, quality office who didn't have someone in charge of the program, missed a few points. Do I believe that patients were harmed because of this? No, I don't. Do I believe there were some areas he was out of compliance? I do. But why did it happen? The employee was late 25 times. After 25 times of being late, and you can imagine if you've got an employee who doesn't show up 25 times, the rest of the staff is very upset at them. They're making all of their jobs harder. They finally had to terminate the person. And I think you and I would consider doing that too, wouldn't we? Yes. Well, so now this ex-employee was able. to weaponize this and to try to make all of their lives miserable. That's how it happened. In terms of what will be the outcome for this doctor, again, because he has a good attitude about it, he's not being belligerent, we're working with him to make sure he has the written documents, that he has the training programs, that he admits, look, I made a mistake. I've got somebody in charge of it now. We have training scheduled every year and as part of the onboarding process. He'll now be sending them proof. But in this case, he is on probation for a two-year period. His license hangs in jeopardy for a two-year period. And during that time, they have said that they will make at least one unannounced inspection. If that inspection is not passed, he'll be on probation. That period will start from day one again, another two years. So you can see how difficult this situation is. Right, but being on probation, that won't prevent him or preclude him from renewing his license as long as he is showing that he's trying to rectify whatever deficiencies there were in his protocol. Is that right? This is what they've told him. This is what they've told him, that if he is willing to make these changes and can provide proof, that he'll continue to be able to practice dentistry. Did you at all inform the board that the employee was kind of a disgruntled employee or was that something wouldn't be relevant to the interaction you're having on behalf of the doctor? Well, in this case, of course, OSHA was in there as well as the state board. In both cases, they were informed that this was a disgruntled employee. Anybody else would have fired him after being five or six times late. Instead, this poor guy, they were extremely nice. Let her go 25 times. Yes, I think that they do take into consideration. Right away, they can see that this has been weaponized. But what do you do when they then go in there and truly do find some violations? Yes, they're small. Yes, you could say they're not significant, but they're not in compliance, which is why I think it's like taking off an airplane. You need to go through that checklist in your office every year to make sure you don't miss the small points. So I think we answered a lot of the questions for infection control. I mean, you know, you give a course for Viva Learning, which every year many, many thousands of dentists take and staff members and hygienists and so forth. And that course updates the practices on all the latest protocol that's most important to make sure that they're all compliant with everything they're doing for infection control. And OSHA goes along with that. They're very tied together. In closing for this podcast, what major recommendation could you make to every practice every year where they need to introspectively look at their practice and say, where am I deficient? Where is their risk? What I would say, quite honestly, the reason, the genesis of our company. almost 30 years ago was because we could see, although I'm trained as a dentist, we work with dentists, physicians, veterinarians across the country, seeing that healthcare professionals don't have the time to really organize these compliance programs. So what would I do? I would certainly, you could certainly go to our website and download for free our audit checklist. And certainly we can. find a way to make it available to your listeners. What would I do? I'd make sure that I'm going through an audit checklist at least once a year, making sure you've checked all the boxes. It used to be I would talk about trying to convince people why they needed to be in compliance because it was the right thing to do. Today, I just say, look, maybe you think these laws are overly burdensome. Maybe you don't agree with all of them, but this is something we've got to do. Business owners, we can lose our ability to practice. We can face steep fines. And even more than that, what about the stomach lining you lose? Can you imagine these two guys I'm talking about, these two partners, what they're going through dealing with this? Get yourself in compliance, and then you can sleep at night. You don't have to worry about this. There's enough things we have to worry about in dentistry. We shouldn't have to worry about this. It's not that hard. Yeah, thank you very much, Dr. Carpenter. I really appreciate your time. Again, for those of you who are interested in learning more about infection control protocol and things you should be doing in your office, Compliance Training Partners has been around a long time. Dr. Carpenter is a dentist and he built the whole program on his knowledge of dentistry from the standpoint of actually practicing and dealing with the issues that we all deal with on a day-to-day basis. He does have some freebies, like he mentioned, these audit checklists that you can download. So look up Compliance Training Partners and you'll really benefit from all that. Thank you again, Dr. Carpenter. Phil, thanks for having me. 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