Constructing Zone Scheduling

Daily Goals

Effective scheduling balances the patient flow while meeting daily production goals. Determine your daily restorative and hygiene goals prior to building your schedule. Your daily goal can be calculated by dividing the annual goal by the number of days the practice is open, excluding holidays and vacations. Ideally, 80% of your restorative production goal is met in the morning, with the remaining 20% in the afternoon. Reserve time in the schedule for larger cases (2-hour restorative blocks), SRP, new patients, and emergencies. The number of large case blocks you need is determined by looking at your procedure coding report to gain historical data. For example, if the doctor completed 192 crowns in 12 months, typically schedules 2 hours per crown, and the practice is open 192 days per year you will need to block out 1, 2-hour block per day to support his/her crown diagnosis. Follow the same pattern to determine the number of other 2-hour blocks the schedule needs to support. Reserve SRP time in the hygiene schedule using the same historical data. Your zone schedule will be unique to your practice and reflect the doctor’s philosophy of care and time needed per procedure.

Constructing Your Schedule

Construct days so that longer, more productive treatment is scheduled in the morning. Schedule hygiene SRP (periodontal therapy) appointments and periodontal maintenance visits (D4910) in the mornings when possible. Oftentimes, these patients don’t require exams, and therefore the doctor can focus on the restorative patient that is receiving more involved treatment. The doctor should have enough time to provide treatment with minimal distractions. This schedule is most effective when the doctor is willing to break for hygiene exams at a convenient time rather than waiting until the end of the hygiene procedure. An exam that is completed in the middle of the procedure allows more time for the patient to ask questions and for the hygienist to support the doctor’s recommendation. This increases case acceptance and prevents time challenges when the hygienist needs the doctor just as he/she started restorative treatment or is taking a breather between patient care.

Morning

Afternoon

Patient Flow and Zone Scheduling

When scheduled correctly, fewer patients are checking in and out in the morning, allowing the front office staff more uninterrupted time for accounts receivable and insurance follow-up, recare follow-up, confirmation calls and other tasks.

Because the hygiene schedule is usually scheduled 6 months ahead, work towards creating Zone Scheduling. Plan to hold your reserved restorative blocks of time for up to 3 days, releasing the block for other treatment in order to keep the schedule full.

Procedural Timing Reference

Successful zone scheduling accounts for time distributed between the doctor and dental assistant for the entire appointment, from the time the patient is seated to dismissed. Dental assistants play a major role in maintaining an efficient patient flow throughout the day and provide services independent of the dentist to maximize patient flow. It is most effective to identify the time needed by the dental assistant in addition to the actual time the doctor expects to spend with the patient by procedure. This is crucial when utilizing 2 columns to schedule the doctor; overlap can be in place during assistant only time. In the crown prep example below at 8:30am, the dental assistant seats and prepares the patient in the first 30 minutes (this includes waiting for anesthetic to take effect), the doctor prepares the tooth during the next 60 minutes and the dental assistant completes the appointment by preparing and placing the temporary crown, providing homecare instructions, dismissing the patient, completing chart notes and op turnover. In this example, the doctor is needed for 60 minutes of the 2-hour crown appointment. This allows staggered scheduling in a second column to increase efficiency and meet patient demand without creating chaos.

*10-minute units of time

Doctors work at a different pace depending on the type of procedure and their experience. A separate Procedural Timing Reference should be completed for each provider. The provider and dental assistant should collaborate to complete this reference guide. There will be times when diagnosed treatment does not clearly fit into the parameters outlined in the reference guide you prepare. In those cases, the assistant, hygienist, or doctor needs to identify time needed within the same parameter for proper scheduling.