Angus Dentistry: Family treating families

State-of-the-art technology, utmost level of care marks office design competition winner for group practices

Story by the Angus Dentistry team. Photography by Karl Steinbrenner and Daniel Butler

For more on this topic, go to www.dentaleconomics.com and search using the following key words: office design, Angus Dentistry, Matsco, family, efficiency, technology.

Our practice philosophy is to give patients the most technologically and scientifically advanced level of comprehensive dentistry, provided by a highly skilled team of staff and doctors, in a warm and soothing atmosphere.

The office design reflects this philosophy in that it marries classical architecture and décor with state-of-the-art technology. Every detail of the facility was designed so that doctors and staff are provided with beautiful ergonomic workspaces for maximum efficiency and minimum stress. During the design process, each staff member and doctor was consulted with to determine his or her needs. As a result, team members have been provided with the tools and space to fulfill their potential in our effort to provide the highest level of dentistry and service for patients in a beautiful and restful environment.

Our practice is located in the heart of a residential neighborhood and is situated within walking distance of many patient homes. It is also just around the corner from an assisted living facility where many of our patients' aging parents live. As a result, we often treat three generations within one family. We have been caring for many families for more than 30 years. Our doctors are a family of dentists. They include Frank L. Angus, DDS; his son, F. Lee Angus Jr., DDS; and his daughter, Rebecca Angus, DDS. Literally, our family treats our patients' families!

Because this family environment is so integral to our practice, we designed the facility to reflect this. The building's exterior blends beautifully into the neighborhood's colonial atmosphere. The interior design gives a feeling reminiscent of a warm and spacious home. We designed an environment that allows staff and doctors to give patients the care we would want for our loved ones and ourselves.

Although we incorporated the best and latest technology in the design for business and clinical care, we created the space so there is nothing institutional about it. The design combines old world ambiance with new world technology, and the space represents a perfect balance of esthetics and functionality. We used warm and soothing colors, furniture, lighting, and textures. The spaces are designed for seamless patient flow and staff efficiency so that neither staff nor patients experience the stress often associated with dentistry. Every detail, from construction to original artwork and the latest available equipment, was designed to reflect our commitment to staff and patients to provide the highest quality comprehensive dentistry and exceptional service in a welcome, comforting, and caring environment.

The reception area is large, open, nicely decorated and has comfortable seating areas for patients. The front desk is welcoming and open with ample space for greeting and dismissing patients, and a private area for financial discussions.

A private, comfortable consultation room with space for six people and multimedia patient education is close to the business office. Each of the administrative staff has a dedicated work area (receptionist, treatment coordinator, financial coordinator, business manager).

We installed Kodak Practiceworks Practice Management software because it automates many staff duties.This makes direct patient care more efficient with features such as chartless office, electronic claims, electronic patient insurance eligibility, and electronic statements with offsite billing. We do computer charting for clear, legible charting, documentation, and communication. We routinely utilize Logicon dental caries analysis for enhanced diagnosis with questionable radiographic caries. We can obtain CareCredit approval within minutes for financing treatment. Doctors have remote access to computers to access patient information from home. We installed a large capacity server to support computer system storage needs and future expansion.

There are networked and Internet-connected computers in every area so staff members can access practice-management software, e-mail, Internet, and other software no matter where they are in the office.

For the clinical staff, computers in each treatment room are located ergonomically for chairside data entry. A monitor is mounted on the equipment cart (behind the patient) with a keyboard and touchpad that is fully adjustable for viewing by the doctor and assistant. The second monitor mounted above the patient's head in the Technology and Lighting Center (TLC) is adjustable for patient viewing. For patient convenience, wireless Internet access is available throughout the office.

Patients easily can move throughout the office via wide hallways and open treatment rooms. There is ample space in treatment rooms for family or caregivers to accompany patients during treatment. There are two large patient restrooms: one near the reception area and one in the clinical area for patients who are in midtreatment.

The six functional treatment rooms have an open design that includes a utility wall and a Pelton & Crane cart system allowing versatile doctor and assistant positioning. The cart system is positioned at 12 o'clock for classic four-handed dentistry. Treatment room side counters are at an appropriate distance to accommodate entry of handicapped patients, and so the doctor or assistant need only to rotate in position to retrieve items on or in counter units. There is no awkward bending or reaching for items during a procedure.

Equipment, supplies, instruments, and placement of materials in cabinet drawers is identical in treatment rooms so that any room may be used for any procedure. This allows maximum scheduling efficiency and flexibility. One treatment room is a dedicated private surgical suite that has a small, comfortable seating area with a reading light and workspace for someone to accompany the patient during treatment. In this suite, there is a large area for central storage of emergency medical equipment and surgical supplies.

Treatment rooms are equipped with Pelton & Crane ErgoSoothe chairs that have a massage feature for patient comfort and relaxation. Treatment rooms have Porter nitrous oxide sedation systems for maximum availability of anxiolysis and easy monitoring by doctors and staff.

We have a VistaClear dental water line purification system for sterilization and to provide pure water to treatment rooms. An additional treatment room is equipped with a chair, light, digital radiography, and computer. This room is used for overflow, imaging, postop checks, and impressions. In the future, this room (and the two remaining treatment areas) will be equipped for full function just like the six current treatment rooms.

The TLC, formerly the Dental Chair Potato, is a dual fiber-optic light that is combined with a multimedia monitor system. The dual light system allows for precise light placement in the mouth, not the patient's eyes. The monitor placement lets the patient view intra- and extraoral images, digital radiography, cable TV, DVD, and patient education from any chair position. Headphones for noise reduction or satellite radio listening are available. Patients love this feature since it distracts and relaxes them.

In the clinical area, the tray prep is centrally located and progressively laid out so that it is only a few steps from treatment rooms. The sterilization area is divided into "dirty" and "clean" areas, and is designed for maximum efficiency and function. The dirty area utilizes three steam autoclaves: a large and a small SciCan Statim, and a large Pelton & Crane. Having three operational autoclaves keeps us from running out of sterile instruments.

In the clean area, procedure tubs and instrument cassettes are located within easy reach and are easily identified. Daily supplies are centrally located to replenish tray set-ups and treatment rooms. There is a computer and telephone station in the tray prep area. Treatment rooms are designed to accommodate hygiene and restorative procedures so there is maximum schedule flexibility. Movable carts are utilized for impression mixing equipment, Cavitrons and Prophy-Jets, and air abrasion units, so this equipment does not need to be installed in treatment rooms.

Film and messy chemicals are a thing of the past in our radiology department. We are completely digital with the Kodak RVG 6000 digital radiography system and the Kodak 8000 digital panorex system. The panoramic unit is centrally located, easy to access, and does not interfere with patient or staff flow. Treatment room monitors and X-ray units are positioned so that an assistant can view a monitor for verification of film accuracy while still at a patient's mouth. These systems provide quick, high-quality, high-resolution images that enhance diagnosis and treatment plans.

We use the Kodak 1000 digital intraoral video camera to image patient education and documentation. We use the Kodak DX 6490 digital dental camera system and the Canon 10D digital camera to import images into a patient's chart for identification, documentation, communication, and treatment planning and presentation.

The lab is centrally located for easy access, and countertops are at an appropriate height for work whether seated or standing. It is well equipped with a Zahn electric handpiece, a large suction dust collector, a lathe, a microetcher, Scheu MINISTAR splint fabricator, light-curing oven, model trimmer, and vibrator. We do a variety of lab work in-house.

There are wall mounts to easily locate impression tray sizes. Lab case tray contents are viewed on slanted shelving. We have installed long counters for accommodating multiple pieces of lab equipment and workstations so at least two doctors and two assistants easily can work together.

The spacious staff lounge doubles as a training room. Numerous wall jacks provide multiple setups for computer, television, video, Internet, and projection. There is the capability for video projection of live clinical procedures. There is a large dry-erase board that also functions as a projection screen. A galley kitchen in this area allows for staff meetings during meal times, special functions, and a private phone room is available for staff use.

The Angus doctors and Cheryl Angus worked closely with Gordon King, design architect with THE Design, and Stephanie Morgan Clarke, interior designer with EnviroMed Design Group, to build a beautiful space that allows us to serve patients the way in which we would wish to be served. Dental technology, dental equipment, function, ergonomics, and esthetics were designed to work perfectly together to achieve our mission and fulfill our vision.

Editor's Note: The annual dental office design competition is sponsored by Matsco, Dental Economics®, and ADA Member AdvantageSM. ADA Member AdvantageSM is a service mark of the American Dental Association. ADA Member Advantage is a program brought to you by ADA Business Enterprises, a wholly owned subsidiary of the American Dental Association. Access the office design competition page on the Web at www.matsco.com/dodc.

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Angus Dentistry Office equipment checklist

CareCredit with direct access
Canon 10D digital camera
Criticare vital signs monitoring unit
Dentsply Cavitrons and Prophy-Jets in all treatment rooms
Dentsply Midwest air handpieces in all treatment rooms
KaVo electric handpiece
Epson photo 2200 photo printer
KaVo DIAGNOdents
Kodak practice-management software with Kodak dental imaging software
Kodak cosmetic imaging module
Kodak 1000 intraoral video camera
Kodak RVG 6000 digital radiography system
Kodak 8000 digital panorex system
Kodak DX 6490 dental digital camera system
Scheu MINISTAR splint fabricator
Pelton & Crane cart system with power wall
Pelton & Crane ErgoSoothe chairs with massage feature
Pelton & Crane Delta XL sterilizer
Porter nitrous oxide sedation systems in all treatment rooms
SciCan Statim sterilizers
DentalEZ Star electric handpiece
Technology and Lighting Center (TLC) in all treatment rooms
VistaClear dental waterline purification system
Zahn lab electric handpiece
Zila ViziLite Plus