Oral Health Group

Compliance Begins When Patients Walk in the Door

November 22, 2016
by Leann Keefer, RDH, MSM

The first touch-point for patients is the reception area and it is critical to make a positive and lasting impression. Patients expect a dental office to maintain high standards of cleanliness and safety, which starts from the moment they enter the door.

Is the room inviting, comfortable, organized and well maintained? Or does the room have stained furniture, empty drink cups, worn carpeting, and year-old magazines?


And it’s even more important to consider cleaning and sanitizing what your patients cannot see. For instance, cold viruses have been shown to survive on indoor surfaces for more than seven days. Flu viruses capable of being transferred to hands and causing an infection can survive on hard surfaces for 24 hours. Flu viruses can also survive as droplets in the air for several hours and low temperatures increase their survival in the air.

As patients await their appointment time, they are a captive audience with ample opportunity to make observations about the area and will take note of things they might have missed if just passing through. While microorganisms can’t be seen, patients can note dust, cobwebs, fingerprints, and dirt. Sticky surfaces can be felt and drink ‘rings’ noticed. Invest ten minutes, sit down, and carefully view the reception area through the eyes of a patient.

Perceptions of the quality of care and treatment can be impacted by the appearance and environment of the reception room. Making a concerted effort to create a feeling of welcome, safety, and security for patients is critical to practice success.

While most dental practices hire a cleaning service for weekly and scheduled maintenance, the reception area sees ongoing patient traffic, which requires daily cleaning and maintenance, with emergency cleanups as needed.

Use of appropriate personal protective equipment during cleaning and maintenance is recommended. The proper level ASTM face mask (Level 1), safety eye protection, and heavy-duty utility gloves should be selected and donned/doffed appropriately. Hand hygiene should be performed immediately after doffing PPE.

Create a consistent cleaning and organizing pattern around the room – clockwise or counterclockwise, it doesn’t matter, just be consistent. Clean from high to low and back to front to avoid dust/debris falling back onto the surface.

Durable washable surfaces which are not only manufactured for commercial use, but healthcare grade will result in easier maintenance. Clean first then use of an appropriate level of sanitizer or disinfectant as indicated based on the surface being treated. The friction of cleaning removes most germs and exposes any remaining germs to the effects of a sanitizer or disinfectant used later. Sanitizing reduces germs on inanimate surfaces to levels considered safe by public health codes or regulations. Disinfecting destroys or inactivates most germs on inanimate objects with the exceptions of bacterial spores and prions. It is important to follow the manufacturer’s instructions for use and maintain the Safety Data Sheet binder for any cleaning materials/products used in the office.

Microfiber cloths and flat mop heads are recommended due to its ability to pick up and hold dirt as well as efficiently absorbing liquid. The absorbency of microfiber is up to seven times their own weight in liquid, which is great for cleaning glass without leaving streaks or for cleaning up spills. It is recommended to have color-coded microfiber cloths for each purpose. Use of machine washable microfiber cloths will cut cost of disposable cleaning products like paper towels. By folding the microfiber cloth into thirds lengthwise and then in half provides multiple clean surfaces during cleaning and dusting. It’s better to spray a cleaning/disinfecting product directly onto the cloth as opposed to the surface to reduce aerosol and respiratory hazards.

Top Ten Daily Activities

  • Windows, Doors, Walls and Mirrors
    Using a microfiber cloth, damp wipe vertical surfaces and ledges, paying particular attention to smudges and fingerprints; use cleaning agents as needed.
  • High Touch Surfaces
    Including, but not limited to, door handles, cabinet knobs, light switches, remote controls, phones, and sink faucets should be cleaned and disinfected daily with an EPA approved disinfectant. If high-touch surfaces become visibly dirty, clean and disinfect immediately.
  • Furniture
    In addition to the carpet, vacuum any upholstered items. Regular vacuuming will remove most germs and keep your furniture looking great. Spot clean any fabric and use appropriate solutions for vinyl and leather surfaces. Dust light bulbs and replace any burned out bulbs. Remember to use plug protectors in electrical outlets to keep little fingers safe.
  • Tables and Wood
    Dust the wood trim on furniture and any tables. A mixture of one-cup olive oil and one-quarter-cup white vinegar will nourish the wood to leave it shining. The vinegar is a natural germ killer that will also clean the wood. Remember to scrub down the furniture legs, the front of the reception desk and other surfaces.
  • Interactive Toys
    Toys, games, play equipment are easily wiped clean. Selecting toys with fewer parts, smooth flat surfaces and washable are best. Disinfect washable colorfast plastic toys with a solution of a half-cup of bleach per gallon of water. Soak for five minutes, rinse and air dry.
  • Electronic Equipment
    TVs, monitors and cords should be wiped with a dry microfiber cloth that is approved for electronics and no scratch surfaces. Judicious use of disinfecting wipes over the entire surface of remote controls, keyboards, and mouse while paying particular attention to buttons to reduce cross contamination. Alternatively, use surface barriers for protection of electronics.
  • Trash and Recycle Containers
    Loose trash should be picked up throughout the day and disposed of properly. Check the trash bin mid-day for emptying; never reach into or push on the trash liner to compress trash; leave liner in container, close the top, twist and tie a knot in the top of the bag. Carry the bag away from your body to dispose in trash container. Sharps used by patients (i.e. syringes) should be disposed of in an approved sharps container. Broken glass be picked up using a dustpan and brush/broom or tongs; it should not be picked up by hand, even if wearing heavy-duty utility gloves. Wipe all surfaces of the trash container with a surface disinfectant wipe and allow air-drying before replacing with a new liner.
  • Flooring
    Carpets should be vacuumed daily using a HEPA filter low decibel vacuum cleaner and spot cleaned as needed; a regular carpet cleaning is suggested every three months. Hard flooring should be cleaned using a broom or dust mop followed by flat-head mop for light cleaning. Use of a string or sponge mop for cleaning up spills is recommended.
  • Odors
    Odors can be particularly offensive to patients and staff alike. A good ventilation system with charcoal filters can help minimize unpleasant odors. Cautionary use of disinfectant/deodorant sprays is recommended as patients may be allergic or have respiratory concerns.
  • PEEP: Place for Everything and Everything in its Place
    Complete a visual check throughout the day for items that are out of place. Organize items in containers, baskets or files to keep them corralled. Clear plexiglas holders and wall mounts keep pamphlets and magazines orderly. Placing office policies in plastic sleeves kept in a three-ring binder is better than posting on the wall. Keep current book titles and issues of magazines available. While studies have shown low fomite contamination of the glossy pages, some offices are removing magazines from the reception area and asking patients to bring their own reading materials and children’s toys to reduce the risk of cross contamination.

Patient Friendly Space
Boxes of facial tissue and pump bottles of alcohol based hand rub should be appropriately placed for patient use in the reception area.

Post respiratory etiquette and hand hygiene signs as a reminder about the proper practice. The “red” cover your cough poster for health care facilities asking people to cover their cough and clean their hands. This poster is available for download in twenty-six languages.

The 11×17 “blue” poster shows the six steps for washing hands with soap and water, or for cleaning with alcohol-based hand sanitizers.

Do you really want to know?
If you really want to know what patients think about your reception area, why not just ask them? They can complete a short anonymous survey while they wait. The rate of return is usually high and patients appreciate being asked their opinion. Clinical care and staff patient relationships are key to having patients return, but don’t underestimate the power of how your office presents itself to patients, after all these patients are putting their trust to keep them safe and healthy.

About the Author
Leann Keefer, RDH, MSM, in her role as Director of Education for Crosstex International, Ms. Keefer works to advance Crosstex’s thought leadership among influential dental care professionals. She proactively identifies trends in the fields of oral care and infection prevention, developing and implementing the corporation’s long-term strategies relating to education and professional relationships.

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