This case study will examine some of the most overlooked areas in a dental practice. Namely the organization of the dental surgery and the sterilization that is required to create a safe environment for both patient and practice staff. In doing so there is a fantastic opportunity to grow the profitability of a dental surgery by increasing the efficient running of the practice, reduce overheads, increase productivity and while most importantly improving the practice safety levels overall.
Sterilization Cassettes – what are they ?
Sterilization cassettes have been around for a long time and are used routinely within institutional settings such as Universities and hospitals. They are devices that can be made of metal or plastic and can come in a range of sizes and shapes. Their primary aim is to hold instruments during the sterilization process however this article will cover the added benefits of their use by covering the various advantages and disadvantages.
1- Patient and staff safety
The biggest advantage in the use of Sterilization Cassettes is the reduction in the possibility of percutaneous injuries (PI) with either sterile or dirty instruments. Although dentists do avail of sterilizing packets these can be torn very easily leaving those people handing the packs at risk. The very fact that the instruments are covered by a hard casing means that possible accidents are reduced during instrument transportation and use as it reduces the amount of time instruments are handled. This will also lead to a reduction in the necessity for staff absences as there will be less need to seek medical treatment post PI and the possible cost that may be passed on to the practice as a result. In today’s litigious culture there’s also the risk or a legal case being taken against you as an employer for failure to provide a safe enough working environment which is an unnecessary anxiety and potentially very costly. We are, as practice owners, duty bound to create a safe environment for those involved in cleaning and sterilizing procedures and this is a simple and straightforward way to do so.
2- Procedure preparation
By preplanning what instruments are used for the various procedures you are undertaking, you can ensure that you and your team is well prepared. Cassettes can be open and laid out for easy instrument access which reduces the time needed to prepare the surgery for any one procedure. They also eliminate the frustration of lost time mid procedure as the assistant has to de-glove and search through cupboards and drawers or, worse still, go to a different room looking for a particular instrument that was forgotten. All while you and the patient wait in likely silence as your treatment time and associated overheads increase.
3- Inventory management
As you have already allocated instruments according to the kit that is prepared, you can reduce the chances of instruments being misplaced as every component has a place and you’ll be clearly able to see incomplete sets immediately. You will also be able to stay on top of your instrument stock and reorder where necessary and not at that critical point during a procedure when the instrument is needed.
4- Reduce instrument breakages
All dental surgeries suffer the inevitable dropping of an instrument. Sadly, there is no getting around this. However, when instruments are encased in a cassette that takes the brunt of any accident the reduction in breakages is reduced substantially. This has the primary method of reducing practice overheads in reorders and the potential down time if an important hand piece is the unfortunate item that is broken.
5- Surgery organization
Another advantage is their capacity to hold a complete set of instruments for a single procedure, thereby eliminating the need to prepare and process multiple packages of instruments. Cassettes can be stored in a convenient and organized manner which creates a sense of professionalism among staff, peers and patients when compared with surgery’s frantically looking for a missing item.
6- Instrument coverage
Being a dentist can be difficult at the best of times but having an anxious patient confront a selection of dental tools prior to a procedure is an avoidable experience. With dental cassettes the surgery can have instruments in place, prepared and left covered until the last possible moment when the patient is reclining. The simple lifting of the cassette lid allows for immediate access and procedure initiation.
7- Extend instrument life
As dental cassettes space items appropriately and generally consist of rails that are constructed of a soft and flexible material, you can prevent scratching of surfaces and unnecessary bending to extend instrument life (e.g. dental mirrors, photography kits, delicate endodontic instruments).
8- Possible improved sterilization
When the instruments are loaded correctly and adequately spaced it allows for complete decontaminant (in the case of liquid submersion) and temperature penetration (during thermocycling via an autoclave) to every area of the instruments concerned. This reduces the possibility of overloading trays or containers during instrument processing and the subsequent loss of sterilization efficacy.
9- Reduced sterilization cycling
When compared to sterilization packets the possibility of an instrument tearing the sealed packet and breaking the seal is reduced thus maintaining instruments within a sterile environment and eliminating the need to cycle unused instruments unnecessarily which will also extend their useful life.
10- Future regulations and safety standards
As patient and staff safety concerns become increasingly more prevalent it doesn’t seem farfetched to see regulators enforce higher minimum safety standards which may include the mandatory use of sterilization cassettes. Instead of potentially having a timeline to complete introduction of these standards forced on you, by being proactive you can implement at a convenient pace for yourself and your staff.
Obviously there is an initial outlay cost in acquiring dental cassettes. However, over their lifetime they will save the practice a substantial sum when broken instruments, scratches and time savings are taken into consideration.
2- Additional storage
As with any changes implemented in an organization there is an element of re-jigging the previous status quo. Cassettes add an element of additional volume that needs to be considered for storage, however these can generally be overcome with appropriate planning and design.
Overall it is the author’s opinion that the benefits substantially outweigh the few drawbacks that are presented above. When you combine the fact that patient and staff safety is paramount within the dental setting, it becomes clear that dental cassettes should be considered by every forward thinking dental surgery.