Most of us have heard the letters before—if you haven’t, you know what they’re communicating. I’m talking about ADPIE—Assessment, Diagnosis, Planning, Implementation and Evaluation.
“Best practice indicates that The Dental Hygiene Process of Care (ADPIE) is the framework within which all dental hygiene therapy should be conducted.” ~ CDHO
If you search the dozens of governing bodies and associations across Canada—and I certainly have—you won’t find any incongruity between them. The standard of care and responsibilities for dental professionals is the same across the country. No matter what province you practice in, Dental Hygienists have a legal and ethical responsibility to ensure that ADPIE is the key to Standard of Care for each client.
Unfortunately, there are still some dental professionals not meeting their ethical and legal responsibilities, at least in Ontario. CDHO publishes a list of their members’ top discrepancies after reviewing their Quality Assurance Portfolios. In 2010, failure to do complete comprehensive periodontal exams was first and foremost. The failure to perform on-going periodontal evaluations turned up on the same list. This means that in 2010 dental hygienists weren’t even getting past the first letter of ADPIE—ASSESSMENT. As we all know, a lack of formal charting makes evidence-based diagnosis next to impossible.
2010 may seem like a long time ago, but do you think anything has changed? No! We’re still faced with the same challenges when it comes to charting. When I ask colleagues why they don’t chart as much as they should, what do I always hear? “We don’t have time!”
So how do we wake up our practices, meet our ethical responsibilities and honour the Standard of Care for our clients by completing comprehensive charting and on-going evaluation? While we as dental hygienists might be able to chart more quickly or efficiently, to be most effective, our practices have a few choices to make:
Allow sufficient time for hygienists to chart alone
Bring in a new team member in part to help hygienists chart
Find an affordable dental software that allows hygienists to chart quickly and accurately on their own
Of course, practices can continue to do what they have always done and own the risk of liability.
The public is becoming more aware and curious about what to expect from their dental care clinicians. Are we prepared for the day when a client asks why we haven’t completed a comprehensive periodontal exam or on-going evaluations? How comfortable are we going to be saying…
”I’m really sorry but I didn’t have time…”
A dental hygienist for 30 years, Tracy Poirier is a trainer and Master Coach with WinTerra. Her writing has featured in numerous publications and she is passionate about inspiring dental professionals to become their best selves. She is currently working on a book titled 'The Indispensable Hygienist: Where the Good become Better and the Better become EXCELLENT!'