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Phased Return to Work

We will all be returning to work in 3 phases, with phase 1 starting on Tuesday and phase 3 a full "new normal" return anticipated at the beginning of 2021. Timings are approximate and will be under constant review according to the general COVID-19 situation and official guidance. As soon as we know exact dates, we will of course let you know.

 

Phase 1

Phase 1 will start on Tuesday 26th May with a trial team of staff, and will grow in capacity in week 3. 

Who will we treat? 
  • Emergency patients that the Partners treated by phone consultation during lockdown (about 200 patients) . These include patients with swellings, trauma injuries and severe pain. All patients will be treated at the Queen Edith's Way practice only.
Which of our team will be back at work?
  • Week 1 (w/c 25/5): Wail, Louise O, Cyrus, Bev, Rosie, Sophie, Ian M.
  • Week 2 (w/c 1/6): Julian, Ian Louise O, Bev, Rosie, Sophie, Ian M.
  • Week 3 (w/c 8/6): All Partners, Louise O, Bev, Rosie, Sophie, Ian M with additional team members to be confirmed.
    (Anne or Gaynor will be in contact with relevant nurses soon as possible.) 
Which procedures will we be doing?
  • It is assumed that all of these patients will require an aerosol generating procedure (AGP).
  • Treatments will be carried out under rubber dam using high volume suction and high volume air filtration.
  • Each dentist will surgery swap, alternating appointments between 2 surgeries to allow time for full decontamination and ventillation.

 

Phase 2

Phase 2 will consist of a gradual return to providing comprehensive gold standard dental treatment and will start once we are have a good stock of PPE, have finessed our treatment protocols in phase 1 and treated the backlog of emergency patients. This date will be under constant review and will follow official guidance.

We will prioritise treating the 2,000 patients currently in treatment alongside daily emergencies.

Who will we treat?
  • During this phase we will gradually return to offering routine appointments, strictly adhering to official guidance.
  • Both practices will be open, with the third surgery at Copley finished and ready to use.
Which of our team will be back at work?
  • All staff including Hygienists.
  • Each clinician will be working in a single surgery (no surgery swapping as in phase 1).
  • Surgery teams of clinician and support staff will be introduced gradually at a maximum rate of one or two teams per week; this is to ensure that everyone is properly trained and fully understands the new protocols for working at Devonshire House.
Which procedures will we be doing?
  • All procedures in all areas. Treatments will be carried out under rubber dam using high volume suction, extra oral suction and high volume air filtration.

Phase 3

The plan is that our full "new normal" will start early 2021 incorporating new offsite/virtual patient handling techniques. PPE will be standardised at a new universal normal level for all procedures and air purification, aerosol control and highlevel cross-infection control maintained. The timing of the transition from phase 2 to phase 3 will be under constant review and in line with official guidance.

 

 

Zones Across the Workplace

To keep everyone as safe as possible we have redefined Devonshire House using 4 zones across all 3 buildings.These cross-infection control zones will not be temporary and are likely to be the new approach to our work for the foreseeable future.

They are designated according to the level of risk with 0 being low risk of contamination and 3 being high and aim to control risk and mininmise cross zone contamination.

 

Zone 0

Which areas are Zone O?
  • Highfield House 
  • Copley Lab 
  • DH Stock Shed
  • Car parks and gardens
  • Lab Car
Risk level
  • Low
  • No more risk than visiting the supermarket.
How to stay safe and PPE
  • Stay in your zone
  • Handle stuff from other zones with care
  • Don't use downstairs clinical zones at Copley
Take care in these areas which are zone 1
  • Crossover areas such as stairs and corridors
  • HH changing area
  • Toilets
Social distancing
  • 2m distance or wear a facemask under 2m
  • Recognise boundaries
  • Regularly clean surfaces, knobs, buttons, switches, handles, doors
  • Keep desks clutter free to facilitate easy cleaning
Personal hygiene
  • Regular handwashing or use of hand gel
    Cough and sneeze into a tissue and bin it
  • Avoid touching your face or mask unless you have just cleanded your hands
  • Careful eating and drinking
Uniform
  • Arrive at work wearing a clean uniform
  • When arriving home wash yourself and your kit

 

 

Zone 1

Which areas are Zone 1?
  • All areas of DH at Queen Edith's Way 
  • Copley ground floor
  • Reception areas
  • Devonshire House offices
  • Devonshire House changing areas
  • Toilets which will be designated as patient, zone 0 and 1 and zone 2 and 3


Plus

  • Highfield House changing areas
  • All crossover areas such as corridors and stairs in all locations
  • Toilets
 Risk level Gathering together so increased risk and extra precaution required  
How to stay safe and PPE
  • Patients and essential visitors only (eg maintenance workers)
  • Follow personal hygiene and social hygiene guidance as in zone 0
  • Socially distance where possible with extra care incrossover zones: corridors, toilets, reception, stairs
  • Wear a facemask in corridors, and reception
  • Use designated toilet for staff working in zone 1
  • Keep out of surgeries
  • Keep away from surgery doors
Uniform

Follow the guidelines below about uniform

 

Zone 2

Which areas are zone 2?

Where patients are being treated or contaminated materials are being handled.
No Aerosol Generating Procedures (NAGP).

  • Surgeries doing NAGP
  • Hygiene room if restricted to NAGP initially
  • Patient side of reception
  • Patient toilets 
Risk level

Increased risk due to close attention to patients

How to stay safe
  • Dentists to define appointments as NAGP or AGP so appropriate zone precautions can be applied
  • Routine hygiene to be NAGP with special hygiene appointments at the end of sessions
  • Minimise visiting other spaces
  • Minimise surface contamination
  • End of AM and PM session 30 minute clean down
  • Change your uniform before lunch 
  • Use designated toilet for staff working in zones 2 and 3 
Uniform and PPE

Wear surgery PPE including:

  • FFP2 or FFP3 mask
  • Visor
  • Scrubs

Follow the guidelines below about uniform

 

Zone 3

Which areas are zone 3?
  • Surgeries doing Aerosol Generating Procedures (AGP)
  • Steri rooms (dirty end)
  • Hygiene  room doing AGP
 Risk level Significant 
How to stay safe
  • Dentists and Hygienists to define AGP's
  • Change uniform before lunch see uniform info below
  • Extra PPE see below
  • Use air filtation systems and continuosly review and respond to aerosol levels using monitors see below
Uniform and PPE Clinical staff will all wear scrubs with extra PPE:
  • plastic aprons
  • plastic sleeved gowns
  • paper gowns/suits (steri)
  • paper hats
  • visors
  • masks

or

Professionally laundered:

  • long sleeve tops
  • trousers/top layer scrubs
  • washable gowns
  • Cyrus's hats
  • visors
  • masks
Reducing aerosol contamination
  • Patients will have a 1 minute 1% hydrogen peroxide mouthwash
  • 0.5%Povidone Iodine will be added to the alpron in the waterline 
  • Patients will be treated under rubber dam
  • High volumes intraoral suction plus extra oral suction ducts
  • Avoid drilling at the end of procedure
  • 15 minutes clean down at the end of each appointment
  • Surgery swap between appointments
  • End of AM and PM session 30 minute clean down 
Air Filtration

All surgeries have our new fresh air filtration units. When on the highest function during and after the AGP during appointments, they will change the air every 3 minutes and every 15 mins on the lower setting prior to AGP starting to reduce noise. They will remain on the highest setting until the room has been cleaned down and is aerosol free. 

Air quality monitoring
Air quality monitors are in all surgery and will continually monitor measure particulate matter in the air to ensure we are always operating under the recommended "safe" level. These levels will be checked continuously by nurse and clinician throught appointments.

When does the surgery revert back to a zone 2?
  • When aerosol is controlled and all surfaces, buttons knobs and switches have been wiped
When do I change from a zone 3 worker to zone 2 worker?
  • When you have removed your top layer of PPE and dipsosed of it into the clinical waste and the professional laundry bag
  • When you have wiped your visor down
  • When you have wiped your shoes

 

 

Uniform information for all staff in zones 1, 2 and 3 at Queen Edith's Way

Beginning of the day

Arrive in your own clothes 
  • Change into work clothes whilst socially distancing
  • Place own clothes into a plastic hanging cover
  • Clinical staff place shoes in a shoe cubby hole
Before lunch Clinical staff only
  • Change into a clean uniform before you eat your lunch
  • Place your used uniform in the pillow case provided and put in your shoe cubby hole.

End of the day
  • Clinical staff leave work shoes in the shoe cubby hole 
  • Change into your own clothes
  • Put your uniform in your pillow case to take home (clinical staff should now have 2 uniforms)
  • Please wash your uniforms and pillow case at home and bring your clean pillow case back the next day.

 

 

A "New Style" Day

As we return in phase 1, a "new normal" day will:

  • Start with a 30 minute set up during which all appointments that day need to be planned for.

  • Each am and pm session will end with a 30 minute clean down to allow for floor cleaning.

  • Each appointment will be an hour long. Treatment will not last for an hour but this will provide enough time to do a 15 minute clean up at the end of every appointment.

  • Patient 1 will be seen in surgery 1. At the end of this appoinment the surgery will be fully decontaminated and then left for 1 hour being fully ventilated and with a HyperHepa air filtration unit running.

  • The next patient 2 will be seen in surgery 2 with this appointment starting while surgery 1 is being decontaminated. At the end of this appointment the same decontamination procedure as surgery 1 is undertaken.

  • After the last patient has left there will still be work to do to prepare for the next day such as administration and phone calls.

  • Phase 1 - during the first two weeks, 2 patients will arrive every hour. Find out more about the patient journery here 

 

Staff Training

This week Wail, Rosie, Janice and Maria were trained how to fit FF2 and FF3 tight fitting face masks and are fully up-to-speed on the recommended guidance. All clinical staff will be fitted for masks as you return to work. We will also be offering this service to our referring dentists.

Rosie, Bev and Louise O, Sophie and Ian have also been at the practice this week learning and refining the new protocols ready for the introduction of phase 1 on Tuesday. As additional teams are re-inducted back to work in phase 2, we anticipate that two days of training will be required for each of them.

How can I prepare for my return to work?

  • Please identify the zones you work in and understand their boundaries 

Clothes and uniform?

  • Be ready to arrive at work prepared with the correct amount of uniform as described in the section above.
  • Arrive in easy to change clothes.
  • Don't bring extra stuff with you.
  • Use your lockers.
  • Take your uniform and pillow case (clinical staff) home every night and wash them and bring clean pillow case back.

What about lunch?

For cross-infection control purposes the toaster, sandwich toaster and microwaves have been removed from the kitchens. Please bring a self contained packed lunch to put in the fridge to help reduce:

  • cooking congestion
  • cutlery/crockery use
  • washing up
  • and eliminate smells

 

The New Patient Journey

Under the new normal, the patient journey will be very different with many not seeing their regular dentist and our primary aim is to keep patients safe whilst constantly reassuring them. 

For a step-by-step guide to the new patient journey click here