Checklist template

Dental practice manager review

A ready-to-use checklist with 107 items in 6 sections, covering Patient experience, Schedule, Clinical records, Staffing, Facility, Financial. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 107 Items
  • 78 Yes / No checks
  • 6 Scored ratings
  • 108 Points

Use this template How audits work

1. Patient experience 17 items

  1. Patient satisfaction survey results for the last quarter have been shared with the team at a meeting Yes / No 1 pt
  2. Patient satisfaction score for the last quarter (%) Number
  3. Average online review rating on the day of the review (stars) Number
  4. Every online review posted in the last 30 days has a reply from the practice Yes / No 1 pt
  5. Patient complaints are entered in a complaint log with the date, the issue and the resolution Yes / No 1 pt
  6. Complaints recorded in the last quarter Number
  7. Each complaint in the log was answered within the time set by company policy Yes / No 1 pt
  8. Patients who transferred their records to another practice in the last quarter were contacted to learn why Yes / No 1 pt
  9. Longest wait observed in the reception area during the review (minutes) Number
  10. Patients asked during the review said their treatment had been explained in words they understood Yes / No 1 pt
  11. Patients asked during the review said they knew the cost of their visit before treatment started Yes / No 1 pt
  12. New patients receive a welcome call or message before their first appointment Yes / No 1 pt
  13. Follow-up calls are made the day after extractions and other surgical procedures Yes / No 1 pt
  14. Complaints about clinical care are reviewed with the treating dentist, with the review noted in the complaint log Yes / No 1 pt
  15. New patients seen last month Number
  16. The referral source of each new patient is recorded in the practice management software Yes / No 1 pt
  17. Patient experience observed during the review Rating
    • Warm, on time and well informed 5 pts
    • Polite but with delays or unclear information 3 pts
    • Patients waiting or uninformed 1 pt

2. Schedule 18 items

  1. A daily production goal is set for each dentist and each hygienist Yes / No 1 pt
  2. Production scheduled today as a percentage of the daily goal (%) Number
  3. The huddle sheet used this morning shows yesterday's production against the goal Yes / No 1 pt
  4. Unfilled dentist hours in the next 5 working days Number
  5. Unfilled hygiene hours in the next 5 working days Number
  6. Cancellations and no-shows last month (% of appointments) Number
  7. The cancellation and no-show rate is reviewed every month by provider and by day of the week Yes / No 1 pt
  8. The hygiene reappointment rate for last month met the target set by company policy Yes / No 1 pt
  9. Active patients (seen in the last 18 months) Number
  10. The manager reviews the next two weeks of the schedule every week and notes the action taken for days below goal Yes / No 1 pt
  11. Provider working days and vacations for the next 3 months are entered in the schedule Yes / No 1 pt
  12. The schedule template of each provider was reviewed with that provider in the last 12 months Yes / No 1 pt
  13. No provider column in the next 5 working days is double-booked without a note explaining why Yes / No 1 pt
  14. The first patient of the day was seated at the scheduled time in each provider's column Yes / No 1 pt
  15. Appointments observed during the review ended within 10 minutes of their scheduled end time Yes / No 1 pt
  16. The dentist arrived for the hygiene exams observed within 10 minutes of being called Yes / No 1 pt
  17. Patients diagnosed with periodontal disease in the last 3 months have their periodontal therapy scheduled or a follow-up noted Yes / No 1 pt
  18. Management of the schedule Rating
    • Full, balanced and running on time 5 pts
    • Gaps or overruns on some days 3 pts
    • Frequent gaps, overruns or double booking 1 pt

3. Clinical records 18 items

  1. Patient charts sampled for this review Number
  2. The medical history in each chart sampled was updated and signed within the last 12 months Yes / No 1 pt
  3. Allergies and medical alerts show as a flag when each sampled chart is opened Yes / No 1 pt
  4. A signed consent is on file for each extraction, root canal or implant in the charts sampled Yes / No 1 pt
  5. The clinical note of each visit sampled is signed by the treating provider Yes / No 1 pt
  6. Clinical notes in the charts sampled were completed on the day of treatment Yes / No 1 pt
  7. Clinical notes sampled record the type and quantity of local anesthetic given Yes / No 1 pt
  8. Adult charts sampled contain a full periodontal charting from the last 12 months Yes / No 1 pt
  9. A diagnosis is recorded for each tooth on the treatment plans sampled Yes / No 1 pt
  10. Treatment plans sampled carry the patient's signature or recorded acceptance Yes / No 1 pt
  11. Radiographs in the charts sampled are dated and labeled with the tooth or area Yes / No 1 pt
  12. Charts sampled record the patient's refusal where recommended treatment or radiographs were declined Yes / No 1 pt
  13. A signed privacy notice acknowledgment is on file in each chart sampled Yes / No 1 pt
  14. Requests for copies of records from patients or other providers are logged with the date they were fulfilled Yes / No 1 pt
  15. Access rights in the practice management software match each employee's role (front desk users cannot edit clinical notes) Yes / No 1 pt
  16. Paper charts and printed day sheets are kept in a locked cabinet or room outside working hours Yes / No 1 pt
  17. The backup of practice data completed successfully on each of the last 7 days Yes / No 1 pt
  18. Result of the chart sample Rating
    • All charts complete 5 pts
    • Minor gaps in a few charts 3 pts
    • Gaps in most charts 1 pt

4. Staffing 19 items

  1. A copy of the current license of each dentist and hygienist is on file at the practice Yes / No 1 pt
  2. Earliest expiry date among the licenses on file Date
  3. Dental assistants performing expanded functions hold the certificate required by local regulation for those duties Yes / No 1 pt
  4. Every clinical employee holds a current basic life support certificate Yes / No 1 pt
  5. Open positions at the practice Number
  6. Employees who left the practice in the last 12 months Number
  7. The staff schedule is posted at least two weeks ahead Yes / No 1 pt
  8. Each dentist on today's schedule has a chairside assistant assigned for the whole day Yes / No 1 pt
  9. Overtime in the last pay period stayed within the hours approved by the regional manager Yes / No 1 pt
  10. New employees hired in the last 12 months have a completed onboarding checklist on file Yes / No 1 pt
  11. Each employee has had a written performance review in the last 12 months Yes / No 1 pt
  12. A team meeting is held every month and its notes are kept Yes / No 1 pt
  13. Date of the last team meeting Date
  14. At least two employees are trained to submit insurance claims Yes / No 1 pt
  15. At least two employees are trained to run the sterilization area Yes / No 1 pt
  16. Employees record their own start and end times in the timekeeping system Yes / No 1 pt
  17. Continuing education hours are tracked for each licensed employee Yes / No 1 pt
  18. Each employee has a signed job description on file Yes / No 1 pt
  19. Staffing against the schedule on the day of the review Rating
    • Fully staffed 5 pts
    • One role short or covered by a temporary employee 3 pts
    • Short in several roles 1 pt

5. Facility 19 items

  1. The exterior sign is intact and lit Yes / No 1 pt
  2. The entrance and the walkway are free of litter Yes / No 1 pt
  3. The patient restroom is clean and stocked with soap and paper towels Yes / No 1 pt
  4. Accessible parking spaces at the practice are marked and unobstructed Yes / No 1 pt
  5. Ceiling tiles above the dental chairs are clean and unstained Yes / No 1 pt
  6. Parking lot and entrance lighting works Yes / No 1 pt
  7. Pest control visits are recorded in the service log on the schedule set by company policy Yes / No 1 pt
  8. No sign of pests was found in the storeroom, the break room or the reception area Yes / No 1 pt
  9. Food and drinks are kept out of the operatories, the sterilization area and the laboratory Yes / No 1 pt
  10. The staff break room is clean Yes / No 1 pt
  11. Fire extinguishers carry a current inspection tag Yes / No 1 pt
  12. Exit signs are lit Yes / No 1 pt
  13. Emergency exits and the corridors leading to them are clear Yes / No 1 pt
  14. The eyewash station is tested weekly and the test is recorded Yes / No 1 pt
  15. The automated external defibrillator shows a ready status and its pads are within their date Yes / No 1 pt
  16. The emergency oxygen cylinder gauge shows pressure above the minimum marked on the cylinder tag Yes / No 1 pt
  17. Maintenance requests are logged with the date they were raised Yes / No 1 pt
  18. Maintenance requests open for more than 30 days Number
  19. Condition of the facility Rating
    • Clean and in good repair 5 pts
    • Minor wear or cleaning gaps 3 pts
    • Visible damage or poor cleaning 1 pt

6. Financial 16 items

  1. Gross production last month (dollars) Number
  2. Staff wages last month stayed within the percentage of collections set by company policy Yes / No 1 pt
  3. Collections as a percentage of net production last month (%) Number
  4. Production of each provider is compared with its goal every month Yes / No 1 pt
  5. Accounts receivable older than 90 days (% of total receivables) Number
  6. The fee schedules of contracted insurance plans were reviewed for renewal or renegotiation in the last 12 months Yes / No 1 pt
  7. Treatment acceptance rate last month (% of dollars presented) Number
  8. Laboratory fees last month (% of collections) Number
  9. The fee schedule in the practice management software was updated within the last 12 months Yes / No 1 pt
  10. The monthly profit and loss statement is reviewed with the lead dentist or the regional manager Yes / No 1 pt
  11. Month-end reports for last month were sent to head office by the due date Yes / No 1 pt
  12. The practice has a written action plan for each key figure that missed its target last month Yes / No 1 pt
  13. Corrective actions from the previous practice review have been completed Yes / No 1 pt
  14. Name of the practice manager Short text
  15. Overall result of the practice review Rating
    • Meets standards 5 pts
    • Meets most standards 3 pts
    • Below standards 1 pt
  16. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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