Although most of us buy insurance we do so on the basis that we think (or fervently hope) that the risks we are insuring our practices against will never actually happen – in other words that we shall never been called upon to manage a dental practice disaster. Of course, the likelihood of the sort of risk occurring which would affect our ability to operate as a dental practice is low; if it were otherwise we wouldn’t find decently priced insurance. However, there is no getting away from the fact that fire, flood, pestilence and other practice changing events can and do occur and insurance, comforting though this might be to have, is really not enough for your practice to continue to operate, pay the staff and earn some money yourself.
Disasters can take a long time to get over and patients need to be seen and cared for during this time. Add to this mix the sobering thought that insurance settlements can also take months to come through. As a principal or manager, you need to have your dental crisis management plan ready to be put into action should disaster strike. And, of course, the CQC would expect you to have such a plan.
In this short article I’ll be setting out an eight-step approach to developing a dental crisis management – in other words, a business continuity plan. While doing so I shall be referring to templates used in the CODE management system, available free to members and reviewed in the annual cycle in iComply.
- M 233-DPL – Disaster Planning and Business Continuity Policy
- M 255 – Disaster Planning and Emergency Procedures
- M 255B – Emergency Actions Notice
- M 217N – Business Impact Analysis
- M 255A – Emergency Contacts Poster
- M 255B – Emergency Actions Notice
The Business Impact Analysis template is completed with an extensive list of potential problems that can affect a dental practice and the steps to take to control their impact; and Disaster Planning and Emergency Procedures, which has a list of suggested actions to respond to a range of problems.
Step 1 Make a plan!
Disasters, by their very nature, are usually unexpected but nevertheless we should try to predict some of the greatest risks that we face. This involves identifying the risks and kinds of disasters you’re most likely to experience and prioritising them. You need to think about the critical business functions in your practice and how quickly these must be recovered. Business impact analysis can be particularly helpful in identifying business hazards and threats and calculating the severity of their impact on your business. Once this is done, you could refer to your own Disaster Planning and Emergency Procedures template to create your crisis management.
Step 2 Secure your property
Make sure your practice is as prepared as it can be to survive an accident, crime or natural disaster. Do a regular check on how secure your building, equipment, computer systems, records and website are. For instance, how many people have access to the burglar alarm code? Have any of them left your employment? Are valuable documents kept in a fireproof cabinet or just in a desk drawer? Refer to the first part of Disaster Planning and Emergency Procedures dealing with environments, facility and equipment problems, their possible consequences and actions to be taken by staff should they occur. If you haven’t done so already, consider photographing all of your valuables and equipment for insurance purposes, and take copies of key documents such as insurance policies.
Step 3 Identify an alternative operational location
Make sure you have arrangements in place now for an alternative location to see patients in the event that you cannot see them in your own practice; this could involve renting a surgery or making a temporary (and reciprocal) arrangement with another practice. However, do ensure that the alternative you identify is not likely to suffer the same disaster as you – if your practice is in an area liable to flooding, don’t arrange with a practice in the same location to offer you accommodation in an emergency, as they may be bailing out the rising waters too! Use a template such as CODE’s Contingency Arrangements to create your own and make sure your Emergency Contacts Poster is kept up-to-date.
Step 4 Prepare a backup site.
Decide where you will carry on the non-clinical business of your practice such as contacting patients, arranging appointments, administration, paying bills etc. This, of course, could be your home. If your information and data are not on cloud computing (and so accessible from any location with Internet access), equip your alternative operations site with critical equipment and data (computer, telephone, headed paper, documentation and record backups etc.).
Do you keep outside the practice premises current and multiple contact information (e.g. home and mobile phone numbers and personal e-mail addresses) for all of your staff as well as contact information for key customers such as your LAT, important suppliers such as payment scheme providers and your insurance company? If not, copies of these should be in your alternative operations site.
It is a good idea to make sure that you and at least one other key person has this information as disaster could strike while one or other of you is on holiday on the other side of the world.
Step 5 Alert your staff
It is usual to train staff for medical emergencies but not business ones! Do make sure that your staff know what the crisis management plan is and when it will be operated. They also need to know when and where they should relocate to work in the event of an emergency. Take your time to go through your Disaster Planning and Emergency Procedures with your staff; role play a couple of options to test their understanding and reaction.
Step 6 How will you inform your patients?
Make sure you have plans in place to quickly alert patients as to what to do and where to go in the event of an emergency. You should have arrangements with whoever updates your website to post this information as a priority on the home page (you can write the copy now).
Your customers also need to know your emergency contact information (check: can you put this on your answering service remotely?), your alternative operational location and what to do about appointments. You can also use Twitter and Facebook to let people know what to do.
Step 7 Collect important documents
If you have to leave the practice premises hurriedly, be prepared to leave with critical records and equipment. Better still, have copies of documents in your alternative location for safekeeping. These should include:
– Your crisis management and business continuity plan and checklists.
– Insurance policies
– Chequebook, credit card(s) and passwords
– Employee payroll and contact information
– Desktop/laptop or tablet computers
– Back-ups for computer records
– Digital images of your business property
Step 8 Cash management
You probably won’t know how long it will be before you can return to your practice. It may be hours but in worst case scenarios it could be months. Be prepared to meet emergency cash flow needs, so take your chequebook and credit card(s) in the event of an evacuation and keep enough cash on hand to handle immediate needs. If you are not already using on line banking you should consider this in order to monitor account activity.
This is one plan that I sincerely hope you will never have to implement. However, having your dental crisis management plan ready means that you can limit the damage as possible, which can only be good for you, your practice and your patients. At CODE we provide templates on Disaster Planning and Emergency Procedures that members find helpful when creating their own dental crisis management and business continuity plans. The iCOMPLY Application schedules the review and training of all the activities related to disaster planning in your annual compliance and practice management cycle.