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Crunching the numbers: Using metrics to improve job performance and patient outcomes

March 20, 2023
Metrics can be intimidating, but when hygienists understand them, they can be harnessed to propel a career to new heights.

Editor's note: This is part two of a series. Read part one here.

If you've read part 1, hopefully you feel a little more open to the idea that tracking metrics can be a positive experience. Here's an explanation of some of the most critical ones.

Read part one of this series here 

The most important metrics

Production: The amount of care you provide, in dollars.

  • Gross production: fee for services before any insurance adjustments/write-offs. Many people refer to gross production as “fake dollars” because if the office participates in-network with insurance, it’s impossible to actually collect or realize the full fee.
  • Net production: the number of dollars produced minus any insurance adjustments/write-offs. This represents the amount of money the office should be able to realize/collect.

Why does it matter?

  • Think of production as the amount of care provided to your patients. If we had a way to measure the decrease in inflammation or teeth saved, we would, but we are limited by the technology we use. The only way we can track how much care you’ve provided is by codes billed and the dollar amount for each of those.

What’s the goal?

  • Hygienists should be able to produce at least three times what they are paid. For example, if you make $45 an hour and work eight hours a day (not including lunch), you would need to produce $1,080 a day. (8 hrs x $45 = 360 x 3 = $1,080)

How do you improve?

  • You can increase your production by seeing more patients or doing more services per patient (production per visit).
  • Ways to see more patients: decrease cancellations/no-shows, effective scheduling templates, accelerated hygiene.
  • Ways to do more services per patient or production per visit: better assessment and treatment planning, improving how you communicate to patients to help them buy into treatment, fluoride, sealants, adjunctive services (laser, perio trays, whitening, etc.).

: The percentage of patients you reappoint (same day) in your operatory for their next visit. If you see 10 patients and make the next appointment (reappoint) for seven of them, your reappointment rate is 70%.

Why does it matter?

  • The foundation of oral health is in the delivery of dental hygiene services. Regularly scheduled preappointed appointments keep patients coming back.
  • This is the single most important way to ensure that the practice will continue to thrive and grow. When hygiene reappointment moves up even 10% (for example, from 80% to 90%), a practice will be twice the size in five years.
  • Dentists waste a lot of money on new-patient marketing. If we truly care about the health of our patients, we will be relentless about ensuring they return for their next visit. This helps the practice grow by ensuring the patient base is active and being served well.
  • Treatment acceptance happens over time. Do not be surprised if a patient does not accept your recommendation for full-mouth scaling and root planing on the first visit. The patient needs to know you care and they need to develop trust in you. You may have to do a couple of less-than-optimal prophies until they are ready to accept treatment. Reappointing the patient creates an opportunity for them to be seen by you and develop trust and rapport.

What’s the goal?

  • 90% or more

How do you improve?

  • Assume the patient is coming back. Do not ask, “Can I make your next appointment?” Assume they want to return and give them options for a similar day/time at the appropriate interval (three, four, six months).
  • If the patient says, “I don’t know my schedule. I’ll call back,” try saying, “That’s OK. Most of us don’t know our schedule that far in advance. It’s really important we get you back, and our schedule books up pretty quickly. Let’s go ahead and get you on the books now. We will give you plenty of notice that it is coming up, and you can reschedule if you need to.”

Perio percentage
: The percentage of your appointments that include perio services.

Why does it matter?

  • If you are in a pedo practice, this may be irrelevant. If you treat adults, it is important to see how effectively you assess, recommend options, and treat periodontal disease.
  • As we know, periodontal disease leads to various other systemic issues. Treating periodontal disease effectively is one of the most important things we do as hygienists.

What’s the goal?

  • Industry benchmarks state that the breakdown of services rendered by hygienists should be 60/30/10: 60% prophies, 30% perio maintenance, 10% scaling and root planing.

How do you improve?

  • There are so many components. Start by breaking down the process. How confident are you in assessments? What is the protocol in your practice for diagnosis? How are you explaining the disease to the patient? Do you know the patient well enough to connect what is happening in their mouth to what is happening in their life? How confident and direct is your communication? Consider recording and listening to yourself to see how you sound. Work with other hygienists to learn from one another.

What gets measured improves

Feeling that tracking your performance and knowing your numbers is a negative thing is outdated and short-sighted. If you truly want to be in the driver’s seat of your career with the confidence and knowledge necessary to negotiate compensation, own your worth, and drive growth, you need to know your metrics and understand them just as well as you do a patient’s perio chart. I hope this information has addressed some of the concerns and myths about metrics and helped you appreciate the importance of data. Information is power, and I hope that all hygienists embrace the power of who they are and what they bring to the table.

Time to take action

I hope you learned something and that you're open to taking action. Here are a couple of options to consider:

  • Find out if your practice uses any software for data analytics (Dental Intelligence and Jarvis are the most commonly used). If you are part of a large group, they may have their own proprietary software, or some practice management systems have analytics built in. Ask for a login to access your information and evaluate your performance.
  • Ask your practice manager/dentist what metrics matter most to them.
  • Build yourself a scoreboard or use the one I’ve provided as an example (figure 1). Before you even set goals, start by tracking your performance for four to six weeks. Once you know a baseline, you can set goals. Once a week, fill in the numbers and reflect on your progress. Find out what other hygienists are doing and see what best practices and tips you can learn from those hitting higher goals. 

Editor's note:
 This article appeared in the March 2023 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.

About the Author

Josalyn Sewell, RDH

Josalyn Sewell, RDH, is a partner at the Dentist Entrepreneur Organization and the cofounder of DEO MAP, a business operating system built specifically for growing dental companies. She discovered her passion for group dentistry when she made the jump from clinician to executive leader, and she’s served in nearly every executive role. Sewell is one of the industry’s most sought-after coaches, facilitating more than 150 full-day executive coaching sessions across the country during the past two years.

Updated January 20, 2023