The Infection Control Coordinator's Impact on Dental Practices

You're listening to the Phil Klein Dental Podcast. Infection control protocol. We hear these words all the time. The question is, do you have someone in your office, an assistant or any other staff member, that is directly responsible and held accountable for maintaining infection control protocol in your office? And this involves every aspect of it, instrument processing, surface disinfection, equipment, and so on and so forth. This employee will become essentially your practice's infection control coordinator, commonly referred to as your ICC. Now, why is it important that you have this designated person in your practice? To answer this question and tell us all about it is our guest, Michelle Strange. Michelle is a registered dental hygienist with a master's in dental hygiene education. She brings over 20 years of experience to her numerous roles in dentistry. You can get more information, including Michelle's ICC guidebook, at levelupip.com. That's Level Up. Michelle will be joining us in just one second, but first, when it comes to fighting dental disease, we all understand the importance of an effective prevention strategy. This includes patient home care compliance, regular hygiene visits, and using the best prevention products available. That's why so many dental practices rely on VOCO's award-winning preventive care product line. Recommended by top dental clinicians, Remin Pro, Proflorid Varnish, Admira Protect, and Grandio Seal are truly and true products that are effective, easy to apply, and result in successful clinical outcomes with high patient satisfaction. Whether it's for fluoride treatment to seal pits and fissures or to treat hypersensitive teeth, VOCO's premium preventive care products help you win the battle against tooth decay and sensitivity. So when you're thinking prevention, think VOCO. Request your free sample today at vocoamerica.com. Michelle, it's a pleasure to have you on the show. Thank you for having me again. So we're talking about infection control, specifically the role in the office known as the infection control coordinator. So to begin this podcast, tell us what that is. What is that role? So the infection control coordinator or the ICC is a role that the CDC actually started recommending in 2003. So it has been 20 years that this role has been out there and we've been discussing it. But very few people in the dental industry has actually heard of this. I believe it's a very crucial role in dental and in health care. And essentially, it's somebody that's going to be responsible for overseeing and implementing infection control protocols. and your procedures. I always like to compare it to your insurance coordinator, your implant coordinator, your treatment coordinator, all of those roles that are the champions of that particular task. So this role is vital to ensuring the safety of both the patients and the team members by preventing the spread of infections within the healthcare setting. The ICC is typically responsible for developing and maintaining infection control policies and doing this team training on either an annual basis or anytime there is a new protocol or a new piece of equipment maybe. They will monitor your compliance, making sure that you're doing all the things like the things that you don't even think about when you're in dentistry day in and day out. And then they'll also stay up to date with the latest guidelines and any new regulations that are coming out related to infection control. I think one of the new ones that everybody's trying to implement is something like dental unit water lines. And so your ICC will champion that particular change in the practice, come up with your policies and procedures, find the products that work best for your equipment and what your instructions for use might say. And then they just take the reins of it and make sure that they then disseminate that information to the team. So I'm a dentist, let's say, and I'm practicing and I have a small practice in a rural area. And I, you know, work on not huge profit margins. And I say to you, well, we don't have a huge practice where we can hire someone specifically like an ICC. Can't my assistant get trained in doing that? So I save the resources to pay this person and pay their benefits when I can just kind of incorporate that into an existing staff member. What's your answer to that? Absolutely. Absolutely do that. I am a hygienist. I've always been the ICC in the practice. I think what's important here is when you are establishing that person who is going to take on this role, they want to do it. Like, don't ask me to be an insurance coordinator in any offices. It just won't work well for anyone in the practice. None of it will because I just I genuinely don't care. I work public health for this. I don't have to fuss with it too much. So I would say give this role to somebody who wants it, somebody who likes to do record keeping, who enjoys like. thinking about the nuances are of our day in and day out like will this disinfectant work for all of our equipment or is it one that we just need to keep in this one room you know like these are just the weird nuances that can save your office actually time and money really in the end and at the end of the day but they are going to make sure you stay in compliance that you're preventing infections that you're you know ordering products that are necessary and proper for everything and then making sure They want to teach others because that's what this role is going to have is like, hey, guys, do you guys remember that we're supposed to have a wipe in each hand? Let me tell you why. So they're going to learn. They're going to keep records and they're going to educate. So as long as that person wants to do that role and they're not just Judy, the assistant that shows up every day, I think it's fabulous to have your assistant do that. OK, so it's it can be an isolated role. The practice is large enough where it's needed to have it that way. Or it could be a dual role, one of two or three roles in a smaller practice. But that person really has to be kept up on all the new CDC guidelines. And like you said, new equipment, new diseases that are being spread and making sure that the office is compliant, which is so important. So with staff turnover being so high, unfortunately, for a dental practice. How can an ICC help with training? In other words, you know, let's say you have a dedicated ICC person and they, for some reason, leave the practice without much notice. And they're pretty much the only ones that really know about what's going on with the infection control protocol and everything you just described. What happens? What do we do? Well, I would just say first that the only time that I've really ever seen anyone have a designated position to the ICC has been a DSO situation, multi-practice offices where that ICC is kind of just taking on that role. Almost everywhere I've ever been as a clinician in the last 23 years or helping offices, it is that dual role because it's not a full-time job for your one practice. I mean, it is in the sense. of like, hey, did you do hand hygiene today? Do we need this? Like, but it's moments out of your day. It's not your full day. Now, when it comes to the team training, I think you hit the nail on the head right now is what if Judy does everything in this practice? She knows the ins and outs and Judy is sick. Judy is gone. Judy's kid now is in the hospital and she's out for the week. What happens to our practice? Our sport tests aren't happening. You know, our autoclave isn't maintained. or even maintenance if necessary? Are we doing our suction line maintenance? That's so critical for the, you know, it's the guts of our practice. Are we doing all the right things? Is it the week that we do dental unit waterline testing and shocking and now that just doesn't get done because chaos coming back from somebody not being in is just crazy? So the ICC in this particular case, in that situation, would... your standard operating procedures they would create your checklist and they would have everything kind of written out this is the protocol for our office and then insert human at that point like everything is kind of done I Michelle the hygienist that never did the spore testing never did the autoclave maintenance I could walk in and be like okay checklist sport test in this cabinet. It's a mail-in. We do this. It goes on the shelf, like bam, bam, bam. That is what your ICC could do. Also, as somebody who is a temp in a lot of practices, I just started temping, I say just last year, was temping in a practice where we had a temp assistant. The entire clinical team outside of the doctor was a temp, like chaos, complete chaos. It would have been so lovely if everything had been labeled properly, that I knew the flow of their sterilization area. I knew that, you know, the intraoral camera and my operatory that I was using got wiped down or it didn't get wiped down. Or if it did, it's not with the wipes that tear it up, you know, that we do suction maintenance at the end of the day. This is where you can find it. All of that can be disseminated via your policies. procedures, but I think even more importantly, your SOPs and your checklist. And that will help then confirm that everyone knows how to be safe in your office. And I say this a lot in my presentations, but just because I have two thumbs and a dental degree does not mean I am an expert in infection control. I know how to do the procedures. I've heard of the things. I understand the logistics of it, you know, ultrasonic package. autoclave right but i don't know how to do that in every office i go into autoclave being paper up paper down i don't know and then if i take all of my old knowledge that i just used in that last practice and i bring it to this practice that's a legacy error and that's where things happen that are breaches that are usually just little tiny errors and mistakes but those add up to more egregious things over time We'll be right back with Michelle in a second, but first, if you're looking to make teeth whitening a successful part of your practice, then you need a system that not only dramatically whitens teeth fast, but also ensures little to no sensitivity. Philips Zoom Whitespeed does both. Whitespeed's light-accelerated technology speeds up the whitening process, clinically proven to whiten up to eight shades in one visit. And what's really impressive is that 99% of patients surveyed experienced little to no sensitivity with Philips Zoom. Philips offers two professional whitening solutions, in-office whitening using Philips Zoom Whitespeed, and take-home whitening, with a range of whitening gels for either daytime or nighttime use with custom trays. For a comprehensive, tried-and-true, state-of-the-art whitening solution for your practice, check out Philips Zoom Whitespeed. To learn more, visit philipsoralhealthcare.com. So out of all the offices that you've worked in and visited, which are many, and you do a lot of training, how many offices percentage-wise do you think have a thorough policies and procedures document, a continual process where no matter who's in that day of the week, they're all observing the right protocol, the policy and protocol, to handle the office in the most effective infection control way? Is that something that you see often, or is that the exception to the rule? Oh, it's not even anywhere I've ever been as a, I actually, that's, I moved my company into that where that is an additional service because so many people don't have the time. They don't want to, they don't know where to start and they almost get analysis paralysis of like, how do I create this SOP? And so I now help people do that because they just weren't there. And it, I think it wasn't really a big. issue until the pandemic, until we started having these staffing issues and we had turnover. We're like, please, if you have a heartbeat and opposable thumbs, come into dentistry. We need you. And then we're like, oh, wait, how do we train these people and make sure that we are not putting our patient safety on the back burner? From a training standpoint, what do you offer, Michelle, from your organization, your company that could help be a solution for this? Well, thank you for that question. So I have multiple things. My first thing that I created was digital courses for the infection control coordinator. So if you are like Judy, the assistant that clocks in in the rural area is wanting to be an ICC, I have about five hours of content that she could just dive into. And it's very how to, how to do this. Like, yes, we have infection, you know, chain of infection. We have ultrasonic testing, but like, let's talk, like, this is what you're going to do. And it also has a bunch of downloads. loads to help with record keeping. But then I created kind of this one on one virtual consulting thing where I will, you know, help. guide you in your SOP creation. So I sit down with your team, you tell me what products you already have protocols you already have, and I write your SOPs for you. And then you test them out. Does this work? Does it sound good? Is it working with the flow? And then we have another meeting, we adjust as needed. But so many times when I do that, people are doing things that are actually unnecessary, like their way. time and products, and we can kind of consolidate and make it a little bit more succinct in their protocols. And surprisingly, they were just doing too much. They were doing a lot of unnecessary things. So you need to learn about the office. that you're trying to provide this information for. So do you get the layout of the office, the number of employees, the number of operatories, how many patients are coming through the door, what kind of machines are in the office? Is that the kind of thing you look at? Yeah, but I do like to do it where it is very much this collaborative approach because of course, like me writing it and then you just like hoping that you do it right. So it's more of like, bring me your IFUs. for your, your instructions for use for the equipment that you're doing, you have in the office, tell me who is going to be your ICC or at least this designated person that's going to do this. So I kind of tackle it that way where you're bringing me all of these things and I actually have you read it to me. Like what does the product that you say or have right now say is the way to shock your lines. Does your instructions for use for your actual unit say that that's okay? Then let's create this protocol. What works in your office? Are you open or on Fridays? Do you go in and do admin stuff? Let's do it that day. Nope, you don't. Let's incorporate it this way. So I do kind of have that like chit chat with them beforehand and they bring a bunch of stuff to the call and then I will collaborate with them and create those SOPs. Yeah, that's phenomenal. Phenomenal service and a great idea and hats off to you for starting that. Thank you. Yeah, so let's talk about... office that goes, you know, I listened to this podcast and I've heard this before and I haven't done it, but I want to do it. I want to designate one person to be my ICC, my infection control coordinator. How do you get started in this role? So really, there's not a formal certification out there, just like if you decided that this is going to be your treatment plan coordinator. But there are places like Mind Level Up Infection Prevention that does that training. OSAP is a fabulous place to send people to get the proper training. OSAP and Danby, which is your dental assisting board, they have partnered to create a test. you can get certified in infection prevention protocols. So I love all of those things. I have all of those. I like to say, go get those too, get those education. And where I think I fit into this protocol is, let's get into the... the dirty of it right like this is what happens in your practice it's your clinical office because sometimes it's like people still are confused about dental unit waterline maintenance and i'm like let's just simplify it like let's get in write these out so essentially it's just getting somebody say this is judy judy's gonna do it you you figure out where which path is which what how much time do we want to give judy to learn this and then kind of go from there from the standpoint of a cdc inspection some of which are not even scheduled. They're kind of surprise inspections. Once in a while, you might even have a disgruntled employee that sees something that they don't really think is by the book, like you didn't check the autoclave for spores in the last two weeks, or the person who was supposed to do it has been on vacation and the office missed it, and they report that because they were fired. For whatever reason, these things happen. Yeah, it does. Does it really help the practice? And it's kind of a, you know, loaded question, but does it really help the practice to have this kind of documentation and an ICC on staff to validate the culture of the office of being really focused on infection control, which is important to that inspector? So actually, when you look at the CDC guidelines, there's a PDF, there's even an app that has a checklist. It's called... dental, you know, infection prevention in the dental setting. Part two, I think question number three is, do you have a designated person monitoring your infection control practices? Part one says, do you have written policies and procedures? Are they a place where people can find? Are they updated? Are they, you know, kind of a living document that you're walking? You know, is it this autoclave that you're actually using? Is it the ultrasonic you're actually using? This is different than OSHA. It is, they cross pollinate quite a lot, you know, the guidelines with them. But CDC is more of your like, I think, well, it's patient safety and then the clinical stuff. And so that is like question one through five on that is about guidelines, policies, written exposure control plans and the ICC. Right. And it seems to me with the all the things the dentist has to worry about, not only the clinical advancements that keep coming up and we're moving into a vastly different world with digital workflow and then the business part of it with. paying the bills and the employees. It seems to me that it behooves the dental practice to have someone else worry about the infection control. And the dentist needs to find someone who, like you said, wants to do this because like you said, you don't want to do the insurance part of a practice. I would have no interest in that too if I was in the same position. That is not what I'm interested in doing. The less I work with insurance companies, the happier I am as a person. But it seems to me that a dentist really needs to take that. that responsibility off his plate, his or her plate, and delegate it to someone who he or she has great confidence in to know that they're going to do the right thing to keep the practice safe and keep the patient safe. CDC is interested in patient welfare. And of course, OSHA is interested in employee welfare. And they do overlap, but you need to have both. But certainly, you need to have CDC guidelines. very strictly and diligently comply to. So I think this is one step in that direction, a major step. And I think it gets better after that, right? Once you get an ICC that you could trust, that does the job, I think the dentist's life is going to be a lot better and the whole practice will be happier. You agree? Absolutely. And one part of this that I probably should bring up more because it really hits home, I think, with a practice owner is an ICC maintains your very expensive equipment. Because infection prevention protocols like suction line maintenance and autoclave maintenance and how we wipe and maintain and sterilize all of those scanners and the digital things that cost us so much money. Your suction lines alone, $30,000 plus for a new vacuum pump. And if you're not doing it properly and it gets clogged with all the pumice, that's not Roto -Rooter that comes out and handles that. That's busting out pipes from your floors. something that's like, Oh God, you know, like, I don't know, it's not important, but it can save you a ton of money on this very expensive equipment that you need and you invested in. And I think having that somebody that is the champion of that, that's like, this is my job and I need to maintain this equipment versus so all of us that are like, I think somebody is doing it. I hope somebody is doing it. That doesn't equal great. I think return ROI on. Yeah, actually, in one of your webinars, we were watching this with a group of people from Viva Learning and a couple of our employees laughed because you said in the webinar, if you don't write it down, you didn't do it. And I'm not sure what that was pertaining to. But basically, you have to document what you're doing. And you can't just said I did that if you don't have a record of it, and it's written down or it's documented, it was essentially to everybody else. in a situation where you need to show that you did do it, you didn't do it. So this is all part of the ICC responsibility. Well, this has been very, very enlightening as usual, Michelle. You have great experience, great enthusiasm. I love the way you speak. We're very happy to have you on our show. And if you want to get in touch with Michelle's company, what contact information can you leave for our audience to reach you? They can find me at my company, Level Up Infection Prevention, and that is levelupip.com. LevelUpIP.com. All right. Check it out, folks. Thank you so much. And we'll talk to you soon, Michelle. Thank you for having me. If you're enjoying this podcast, please leave a review or follow us on your favorite podcast platform. It's a great way to support our program and spread the word to others. Thanks so much for listening. See you in the next episode.