Dental Office 
Even Your Files Need Regular Cleaning
"We keep charts on each one of our 5,200 patients and, because we usually see people for cleanings every three to six months, the folders get handled a lot," says Kathy Delaney, who manages a dental office. Some of the charts go back to 1983, so they have to stand up to wear and tear.
The files also have to look presentable, since in Delaney's office -- as in many dental offices -- the file cabinets sit behind the receptionist, in plain view of patients as they arrive and depart. "A messy filing system does not inspire confidence," Delaney says. In her office, the files look remarkably neat and well-maintained.
Delaney uses Smead rotary files , a back-to-back system that rotates for easy access. One rotary file holds the same number of records as three four-drawer lateral cabinets, but uses as little as one fourth the floor space. That explains how Delaney manages to store more than 5,000 records in what looks like only three filing cabinets. "Clever, no?" she inquires. The office does maintain extra storage in the basement for records belonging to patients they haven't seen within the past 18 months.
Being organized reduces labor costs
A major part of the workload for administrative staff involves pulling charts for the patients who will be seen the following day. "When one of us calls to remind the patient about the next day's appointment, we like to have the chart in front of us," Delaney says. And of course, dental appointments not being on everybody's list of favorite things to do, a lot of people ask to reschedule, so the files have to be put back.
Delaney's estimate of the ways her staff spends their time is typical for offices that handle the volume of records she has to maintain. Studies have shown that more than 80 percent of the cost to maintain paper records can be attributed to personnel time spent retrieving and replacing documents. Further, personnel cost to handle records averages more than 20 times the cost of the records themselves.
It also cuts down on stress
"We really hate to waste time looking for a mis-filed chart," Delaney says. It's not just the cost of personnel time that bothers her, it's the resulting panic. No office needs to experience the blaming and finger-pointing that accompany a crisis like a lost file. "Especially for our practice," she says. "We see a lot of families, and children can sense adult tension. They're already anxious when they come to see us. We don't need to add that by being stressed ourselves."
But don't let just anybody do your filing
"At the end of the day, we might have 100 files that either have to be replaced or stacked in order of appointment time and which dentist that patient will see tomorrow," Delaney explains. "There's a lot of margin for error. We learned the hard way that we have to have qualified people filing our charts. We don't let amateurs 'help' unless they know what they're doing."
Delaney's office files alphabetically by patient's last name, using a combination of colored file folders and color-coded labels. The colors segment the file into smaller, more manageable sections of the alphabet. The A's are easily distinguished from the B's and so on. When you are talking about more than 5,000 patients, that's a lot of folders. "The color coding is crucial," she says, "But the system is actually pretty simple."
The patient's name appears on the top of the chart. The color of the folder and the color-coded alphabetic labels designate the first two letters of the last name. In addition to the color coding, Delaney uses file guides to direct the user to the correct section of the system. Filing and finding are much faster with a file system that breaks the alphabet into smaller, defined parts.
And use Smead accessories
File guides are one of the most helpful things about the Smead system. The guides divide a large numbers of folders into smaller groups on the shelves. Like signposts on a highway, guides stand out from the folders to signal major divisions in system. "You already know in general where the file belongs because of what color it is," Delaney explains, "but the file guides really help." Most alphabetic systems place a file guide where each new letter of the alphabet occurs or -- in a system as large as the one Delaney works with -- at the beginning of significant intervals, usually about 100 folders each, she says. "Makes it much easier to find and replace the file."
Clear vinyl pockets for x-rays are also handy, Delaney says. Smead makes a variety of sizes for items that need to be attached to the inside of a chart. And with year labels on the outside of the folder, Delaney can see at a glance when a patient first visited the office, and how long it's been since that patient's last appointment.
"It's all part of the way we care for our patients," she says. "We have their charts ready, we remember their names, we know when they were last seen and what this particular appointment is for, whether they're here for a cleaning or a root canal. We try to make their experience in the front office as pleasant as possible."
Reproduced with permission. Copyright © 2007 by the Smead Manufacturing Company
