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Highly Sophisticated Scheduling Design:

The design of a highly productive and sophisticated, smooth and flexible orthodontic schedule follows a sequence of thought and data gathering.

1. Define the doctor's Tx Mechanotherapy (the Full, Ph-I, Ph-II and Limited services provided).
2. Define realistic exam, consult, initial Banding/Bonding, and DeBand/DeBond appointments, which realistically account for both the doctor and assistants' treatment time IN SEQUENCE.
3. Define your day: the specific number of columns, start and end times and the lunch hour.
4. Define the number of each appointments you need per day, for example, a 1.0 FS/D schedule may need 2 exams, 1 consult, 1 initial banding and 1 debanding.
5. Design the schedule for the maximum doctor productivity, or, if the doctor has a lot of potential growth, design progressively more productive schedules as you grow, increasing production and staffing as needed.
6. Arrange these appointments in the various columns on your scheduler so that the large intervals of doctor time DO NOT OVERLAP. See example below of a 1.50 Full Start/Day schedule; the black blocks represent Dr-Tx-Time.

The above example schedule is based on the following example appointments and calculations. If you require more assistance in designing your schedule, refer to deanbellavia.com for books and Microsoft Word and Excel scheduling design files. See examples below for appointments and calculations for the above sophisticated schedule. If you desire the ultimate schedule, refer to the above website.

Example Tx Mechanotherapy: (These example mechanotherapy is available to be edited on a Microsoft Word file).

Full Treatment Appointments:

Starting & Band/Bond Appointments:
Exam, Records, and Case Presentation, SEPARATE U&L 6's
BAND U&L 6's, BOND U&L 5-4-3-2-1's; U&L 016 NIT AW's
BOND U or L 7's and Re-BOND 1-6 brackets as needed.
Archwire Change Sequence:
Change from U 016 NIT to U 016 SS and from L 0165 NIT to L 016 SS
Change from U 016 SS to U 018 SS and from L 016 SS to L 018 SS
Change from U 018 SS to U 16x22 SS and from L 018 SS to L 16x22 SS
Remove, Reshape and Reinsert U or L AW's 2 times each.
Remove, Reshape and Reinsert U& L AW's 2 times.
DeBand & Retention:
Acct. Check, Retn. Evaluation & End of Active Tx PCD Letter
DeBand/DeBond All, U IMP for Hawley, L IMP for 3x3 Retainer, RR
Next Day, Insert U Truform Retainer
In 2 weeks, Insert U Hawley and L 3x3 Spring Retainers
6 Retention Checks in: 1 mo, 2 mo, 3 mo, 6 mo, 12 mo = 24 mo. retention

PHASE-I or LIMITED Treatment Sequences:

Example Treatment Sequences: (These example sequences are available to be edited on a Microsoft Word file).

Communications (Treatment Coordinator) Appointments:
New Patient Exam:
TC = 20 minutes: New Pt. Welcome, History Taking, Imaging if used
DR = 15 minutes: Dictated Orthodontic Exam & Discuss Findings
TC = 10 minutes: Discussion of Finances, Appts, & Communications
Tx Consult/Pt. Orientation:
TC = 30 minutes: Setup, Discuss Dx & Tx Plan, Financial Arr., Coop.
DR = 05 minutes: Summary of Goals for Treatment & Cooperation
TC = 10 minutes: Appointments and Communications & PO
Pre-Active Tx Recall & Phase-I Observation Recall:
TC = 05 minutes Obtain & Seat Patient & Parent
DR = 05 minutes: Doctor examines Pt. & Gets them involved in Tx
TC = 05 minutes: Reviews anything required or sets up starting Appts
Parent Conference: 
TC = 10 minutes: Discussion of Problems & Solutions
DR = 05 minutes: Decisions on Resolving or Stopping Treatment

Records & Patient Training Appointments:
Initial Records & Retention Records Appointment: 100%
RT = 30 minutes: Ceph, Pano, U&L IMP, Wax Bite, Photos, Process
Miscellaneous Records:
RT = 15 minutes: To Take & Process Pano

Appliance Insertion and Removal Appointments:
BAND U&L 6's; BOND U&L 5-4-3-2-1's; U&L 016 NIT AW's
BAND U&L 6's; BOND U&L 2-1's; U&L 016 NIT AW's
BAND 4 Teeth; BOND 12-20 Teeth; U&L AW's 
DA = 20 minutes: Pt. Prep, Remove Seps., Clean, Fit Bands 
DR = 02 minutes: Check & Adapt Bands 
DA = 15 minutes: Remove Bands, Polish Cleats, Mix Cement 
DR = 10 minutes: Cement Bands 
DA = 13 minutes: Clean Excess Cement, Prep for Bonding 
DR = 20 minutes: Bond Brackets, Final Pt. Check-out
DA = 25 minutes: Insert & Ligate AW's, Pt. Instr., Clean-up
BAND U 6s; BOND U 2-1's; U AW
BAND 2 Teeth; BOND 4-6 Teeth; Insert AW
DA = 20 minutes: Pt. Prep, Remove Seps., Clean, Fit Bands 
DR = 02 minutes: Check & Adapt Bands 
DA = 13 minutes: Remove Bands, Polish Cleats, Mix Cement 
DR = 10 minutes: Cement Bands 
DA = 08 minutes: Clean Excess Cement, Prep for Bonding 
DR = 12 minutes: Bond Brackets, Final Pt. Check-out
DA = 25 minutes: Insert & Ligate AW, Pt. Instr., Clean-up
BOND U &/or L 7's; U&L AW's 
BOND U or L 3-2-1's, Insert U or L AW
BOND U&L 3-2-1's, Insert U&L AW's
BOND U 3-2-1's or U C-2-1's, Insert U AW
BOND 7 to 16 Teeth; U&L AW's
DA = 20 minutes: Pt. Prep, Remove Seps., Clean, Prep Bonding 
DR = 15 minutes: Bond Brackets, Final Pt. Check-out
DA = 25 minutes: Insert & Ligate AW's, Pt. Instr., Clean-up
BOND 1 to 6 Teeth; U or L AW's 
RE-BOND 1 to 6 Teeth; Replace AW's
DA = 10 minutes: Pt. Prep, Remove Seps., Clean, Prep Bonding 
DR = 05 minutes: Bond Brackets, Final Pt. Check-out
DA = 15 minutes: Insert & Ligate AW's, Pt. Instruction, Clean-up
FIT U or L 6's; U or L IMP for Fixed Appl. 
FIT U 6's; U IMP For Expansion Appliance
FIT U 6's; U IMP For U Quad Helix
DA = 15 minutes: Pt. Prep, Remove Seps., Clean, Fit Bands 
DR = 02 minutes: Check & Adapt Bands, Final Pt. Check-out
DA = 13 minutes: U&L IMP, Re-separate, Pt. Clean-up
INSERT U or L Fixed Appliance
INSERT U Expansion Appliance
INSERT U Quad Helix
DA = 15 minutes: Pt. Prep, Remove Seps., Clean, Mix Cement
DR = 08 minutes: Check/Adjust/Cement Appl., Final Check-out
DA = 07 minutes: Clean Excess Cement, Pt. Instr., Clean-up
U&L IMP for Bionator, Etc., Removable Appliance
DA = 10 minutes: Pt.. Prep, Set-up, Size Tray, U or L IMP
DR = 10 minutes: Check Impression, Final Pt. Check-out 
DA = 10 minutes: Pt. Clean-up & Check-out
INSERT Bionator, Etc., Removable Appliance
DA = 05 minutes: Pt.. Prep, Adapt Appliance
DR = 15 minutes: Insert/Adjust Appliance, Final Pt. Check-out 
DA = 10 minutes: Pt.. Instr. with Parent, Cleanup & Check-out
Change to U and/or L Non-Loop Round or Rectangular AW's
DA = 13 minutes: Pt.. Prep, Remove AW, Form/Insert/Ligate AW
DR = 02 minutes: Final Pt Check-out
Remove, Reshape and Re-Insert U or L AW's
DA = 10 minutes: Pt.. Prep, Remove AW, Patient Brushes
DR = 05 minutes: Adjust AW's and Special Ligation
DA = 15 minutes: Archwire Ligation, Pt. Cleanup & Check-out
Remove, Coordinate and Re-Insert U and L AW's
Change to U or L Closing Loop AW
Insert Extrusion Auxiliaries
DA = 10 minutes: Pt.. Prep, Remove AW, Patient Brushes
DR = 12 minutes: Adjust AW's and Special Ligation
DA = 08 minutes: Archwire Ligation, Pt. Cleanup & Check-out
Change to U and L Surgical AW
DA = 10 minutes: Pt.. Prep, Remove AW, Patient Brushes
DR = 20 minutes: Adjust AW's and Special Ligation
DA = 15 minutes: Archwire Ligation, Pt. Cleanup & Check-out
FULL DeBAND/DeBOND All, U&L IMP for Retainers, Retn Records
DA = 05 minutes: Pt.. Prep., Set Up Handpieces
DR = 02 minutes: Check for DeBand
DA = 13 minutes: Remove All, Clean Cement
DR = 15 minutes: Remove Composite, Final Pt. Check-out
DA = 28 minutes: Polish, IMPs, Pan Photos, Pt. Instr., Clean-up 
Ph-I DeBAND/DeBOND All, U or L IMP for U or L Retainer
DA = 05 minutes: Pt.. Prep., Set Up Handpieces
DR = 02 minutes: Check for DeBand
DA = 08 minutes: Remove All
DR = 10 minutes: Remove Composite, Final Pt. Check-out
DA = 20 minutes: Polish, IMPs, Pan Photos, Pt. Instr., Clean-up
INSERT U Trutain Retainer
INSERT U &/or L REPLACEMENT Retainers
DA = 5 minutes: Pt.. Prep, Try-in, Insert Retainers
DR = 3 minutes: Check & Adjust Retainers, Pt. Check-out
DA = 7 minutes: Pt.. Instr., Retn Conference, Clean-up
INSERT U Hawley & L 3x3 Spring Retainer (use 2B)
DA = 5 minutes: Pt.. Prep, Try-in Retainers, Prep Bonding
DR = 10 minutes: Check/Adjust Ret., Bond L Ret, Pt Check-out
DA = 02 minutes: Pt.. Instr., Retn Conference, Pt. Clean-up
All Fixed Appliance Adjustments (HG, Reties, etc.)
Sched. Chair Time = 15 minutes
Total DR Time = 03 minutes 
Total DA Time = 10 minutes 
All REMOVABLE Appl. Adjustments (Retainers, Bionators, etc.)
Sched. Chair Time = 15 minutes 
Total DR Time = 04 minutes 
Total DA Time = 05 minutes 
SHORT SOS/Emergencies (Pain, Minor Problems)
Sched. Chair Time = 15 minutes 
Total DR Time = 02 minutes 
Total DA Time = 10 minutes 
LONG SOS/Emergencies (Loose or Broken Appl.)
Sched. Chair Time = 30 minutes 
Total DR Time = 05 minutes
Total DA Time = 20 minutes

Examples of Determining the Least Appointment Codes:

• The above treatment sequences are reduced to a set of appointment codes by creating "composite Appointments." Composite appointments create one appointment code for many appointments, allowing for the correct amount of DA time and DR time.
• An example would be a two-unit banding/bonding type appointment (2B) to satisfy the above treatment sequences for: BOND 1 to 6 Teeth; U or L AW's - RE-BOND 1 to 6 Teeth; Replace AW's - FIT U or L 6's; U or L IMP for Fixed Appl. - FIT U 6's; U IMP For Expansion Appliance - FIT U 6's; U IMP For U Quad Helix - INSERT U or L Fixed Appliance - INSERT U Expansion Appliance - INSERT U Quad Helix - U&L IMP for Bionator, Etc. - INSERT Bionator, Etc. with the sequence: DA=10, DR=7, DA=13 minutes.
• The composite appointments are then placed in an Excel spreadsheet and the total doctor, TC and assistant times are calculated for varying levels of production.

Example Calculation of Appointment Codes Needed/day:

The table below shows the doctor and team member needs for a schedule that increases the team's productivity from 0.81 to 1.50 full starts/day. This is an 85% increase in production.

7.5 Avg. Hrs/Tx-Day, Presently: 196 Full starts in 200 Tx-Days/Year, Desired: 180 Tx-Days/Year