A lean dental office needs to understand the 90% Rule

What procedures do you perform 90% of the time? Although you’ve probably never really thought about this question, it shouldn’t take you long to answer. The fact is, there are probably a small number of procedures that you do 90% of the time. And now that you’ve identified those procedures, just write them down so that I can help you implement one of the most fundamental principles of LEAN thinking – the 90% Rule.

What is LEAN thinking? It’s all about maximizing customer experience, while minimizing waste. It’s a way to think about how to organize your day-to-day processes to deliver more benefit to your patients, without overloading the work of your team. The 90% Rule is the first step in creating a LEAN culture in your dental practice.

Dental tubLet’s say that you are a general dentist. The procedures performed 90% of the time in your dental practice are hygiene recare, crowns, and fillings. So, ideally, your operatories would be stocked identically with one week’s worth of the supplies required for hygiene recare, crowns, and fillings. It’s that simple. And make sure to keep all of the necessary materials stocked visually and within arm’s reach.

Now, let’s break it down even further. Your 90% procedure profile is the first step in applying a LEAN Culture into your dental practice. For those practices with multiple providers (dentists), it’s important to simplify your supplies first. In other words, discover one bonding agent that all doctors can agree to work with that will cover 90% of all procedures that require a bonding agent. What shade of composite do you use 90% of the time? A2? Good, let’s stock our operatories with one week’s worth. If you have a one off, esthetic case, let’s find a way to deploy it quickly. Just don’t stock every operatory with sixteen shades of composite material. Ask me how many expired compules of composite material I have sorted out of dental operatories over the last eight years. No, don’t! The answer might make you throw up.Dental bin

I haven’t forgotten about your 10% procedures like endo and implant placement. I will save it for another blog. But if you enter the pulp during that MO on #29, rest assured, that endo cart is already on its way. Doctors, please don’t leave the treatment room!

Processes in your dental practice must be simple and standardized. The images above reflect standardized work examples of an Ergonomic Products Megatub and Consumables Bin after a successful Dental Reboot. I have yet to come across a practice that could not fit their typical supply products in one single Megatub. Without standardized work examples and standardized procedure processes, the work becomes challenging. I’m being kind here – the work is a nightmare! Standardized work examples can be duplicated, repeatable and scalable. But most importantly, these standards are easy to coach and manage.

Dental staff during Reboot Training

Image Courtesy of Dr. Williams, Daily & Frazier – Raleigh, North Carolina

I recently completed a Reboot Practice Productivity Training in one location of a small Dental Provider Organization (DPO) that supports five dental practices in Northwest Florida – each staffed with associates. It was a huge success and one that will pay dividends in the long run. You know the training was a huge success when the owner, Dr. Nathan K exclaims, “Angie, you just saved me six figures this year! How quickly can I get you into my other four locations?”

This stuff works. I am not trying to sell you anything. I am trying to change the way you think. You should always think LEAN in your dental practice, and the 90% procedure profile is a good place to start. You will open up so many more opportunities for your team, your practice, and your community, who deserve to be treated by the best dentist in town – YOU!

We can come to you and implement LEAN Principles in your dental practice. For more about Dental Reboot Practice Productivity Training, please email me, Angie Bachman, Director of Clinical Education and Dental Reboot Practice Productivity Training at abachman@desergo.com. Each week, I travel to a new city across North America implementing principles that improve the way you work, and increase dental office production.


Author Angie Bachman