Photo By erika figueroa | YOKOSUKA, Japan (April 26, 2019). A packed audience of dental assistants, providers...... read more read more
By Maricar Gallardo
Navy Medicine West Regional Lean Six Sigma Black Belt
A Directorate of Dental Services (DDS) Continuous Process Improvement team has successfully implemented a safety program aimed at protecting patients and staff from, and to raise awareness about, the blue light hazard posed by light emitting diode (LED) Light Curing Units (LCU) used daily in our dental clinics. When activated, LED LCUs produce blue light that hardens dental filling materials. Exposure to this blue light without the use of personal protective equipment (PPE) presents a Blue Light Hazard, or the potential to cause photochemically-induced injury to the retina.
Recognizing the low awareness about the Blue Light Hazard among our dental staff and their inadequate use of PPE, DDS launched a Lean Six Sigma (LSS) project in February 2019. Led by Operative Dentistry provider CAPT Elizabeth Gaskin, the project team is composed of dental providers and Hospital Corpsmen. Then Director of Dental Services CAPT Johvin Perry championed the project. New Director CDR Shawn Teutsch has continued to provide leadership commitment and support to the initiative.
Following the Define-Measure-Analyze-Improve-Control methodology, the team clearly described the problem, gathered data, performed analyses, conducted research, sought inputs from subject matter experts, brainstormed improvement ideas, and selected appropriate solutions.
Among the subject matter experts the team consulted were Naval Hospital Yokosuka Industrial Hygiene Officer LT Maccon Buchanan, Ophthalmology Department Head LCDR Gabriel Valerio, Optometry Department Head LCDR William Becker, Medical Repair Chief HMC Eugene Alvarez, and Resource Management Director LT Rodney Noah. The project team also sought guidance from the TriService Vision Conservation and Readiness Program and consulted with the former director of the Naval Ophthalmic Support and Training Activity.
The project team focused its efforts on educating the dental staff about the Blue Light Hazard and safe use of the LED LCUs. The team developed multi-media training, which includes a PowerPoint-aided oral presentation and a safety video, now accessible on Relias Health training website. The team also developed respective scripts for adult and pediatric patients to explain the purpose of LCU use in their treatment.
The project introduced several other important improvements. It developed a measurement system to track the light output of every LED LCU in the dental clinics and launched a Know-Your-Number Campaign to encourage providers to track the light output, measured with the use of a radiometer and expressed in mW/cm2, of the LCUs in their treatment rooms. The light output measure dictates the appropriate curing time for dental restorative material.
The team measured frequency of LED LCU use among its users to develop a personnel blue light exposure and risk profile. It also developed an inspection process to ensure defect-free LCUs. Finally, the team established Standard Operating Procedures (SOP) to address various facets of LCU use, all aimed at promoting patient and staff safety from the Blue Light Hazard.
With greater understanding about the Blue Light Hazard, the Directorate of Dental Services immediately took action and purchased Blue Blocker safety glasses, which offer 99% protection from blue light, for patient and staff use.
To promote knowledge sharing, LT Sally Claassen, DC, led the team in reaching out to the Branch Health Clinics (BHC) in Sasebo, Atsugi and Diego Garcia to improve BHC knowledge about safe use of LCUs. Since then, the BHC dental clinics have promoted blue light safety awareness and acquired radiometers to regularly measure LCU light output. DDS CDR Teutsch has also increased the purchase of Blue Blocker safety glasses to provide this critical PPE to the BHCs.
This project has successfully achieved its goals. By June 2019, the Naval Hospital Yokosuka Dental Directorate blue light safety program had been solidly in place and 100% of its personnel (including those from the Fleet clinics) had completed the safety training. The Navy Medicine Professional Development Center has already reached out to the project team to learn from this engagement for what it can teach the rest of the enterprise.
The team members unanimously found the project experience educational and rewarding, and worth all the hard work. Dental providers LT Claassen and LT Ray are both pleased that the project tackled this important topic. LT Claassen explains, “Before this project, I did not know how to test my light curing unit and I did not know the strength of my LCU light output. In undertaking the research for this project, I discovered that knowing the light output reading is extremely important in performing my dental treatments. The safety information is also very informative and beneficial. This topic is highly valuable to the dental community.” LT Ray, who led the LCU light output measurement initiative, adds, “I think it has brought all of the providers some peace of mind knowing better now.” HM3 Van Dike agrees, “I came to understand the LCU equipment with more depth and learned the importance of using personal protective equipment to protect our eyes.”
The team members also expressed how much their participation in the project has contributed to their professional development.
HM3 Van Valen declares, “My involvement in the PI project has had a substantial impact on me. Not only has it broadened my horizons in dental matters, it has also changed some of my own processes as the Work Center Supervisor. I find that I have a much more expanded perspective on what is happening clinically in the department than I did before. The PI project allowed me to disassemble the process I use as a technician and apply what I have learned to my supervisory position to better guide other dental assistants.” HM2 Nguyen echoes the sentiment, “My participation in this project taught me how to break down a complex system into parts and properly conduct a process improvement project.”
Thinking about the six-month engagement, Project Lead CAPT Elizabeth Gaskin reflects, “The most important factor that contributed to the success of this project was the composition of the team. Team members were enthusiastic and hard-working and were fully engaged in the project. They supported one another. The Process Owner’s engagement made a very positive impact on completing tasks on time. LSS Black Belt mentoring contributed to the project’s smooth flow, guiding us through the project. The Director’s tremendous support was invaluable.”
CAPT Gaskin is also grateful for the multidisciplinary collaboration, adding, “While having a team composed of staff from the same Directorate helped in terms of easy contact and communication, SMEs from other Directorates added depth to the project.”
| Date Taken: | 07.26.2019 |
| Date Posted: | 10.04.2019 03:35 |
| Story ID: | 343560 |
| Location: | YOKOSUKA, KANAGAWA, JP |
| Hometown: | YOKOSUKA NAVAL BASE, JP |
| Web Views: | 146 |
| Downloads: | 0 |
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