Articles, Dentistry

Ministry of Defence fit for action

It is not often one gets the chance to work from a blank slate. But A-dec and Wright Cottrell were recently afforded the opportunity and entrusted with the start of a dental legacy by the Ministry of Defence (MoD).

The task was to design a fully compliant dental centre so robust that the design and workflow concept could be rolled out across the armed forces estate.

A-dec’s Christopher Cox and Wright Cottrell’s Iain Lee tendered for the supply of dental equipment to the MoD and A-dec masterminded a new way of working for the entire Defence Dental Services.

Christopher Cox of A-dec was presented with a blank canvass and the need for an ergonomic dental centre. Starting with the Joint Service Publication on dental centre design and ultimately refining it specifically to current best practice standards and what the Defence Dental Service (DDS) needs in the 21st century.

Through an exhaustive process the companies were trusted with the development of the clinical aspect of the new dental centre design, which would become the blueprint for all future DDS new-build sites.

Different needs

The needs of the armed forces are different to that of a high street practice. It is a pure way of working because there is no commercial pressure. The client is solely concerned with having the right equipment and the right design so that patients can have dentistry performed to the highest standard, as the health of our service personnel is paramount.

The dental team at DISC Chicksands

Christopher said: ‘We have worked on the design for some time in conjunction with DDS personnel and it has proven to be successful at the first of the DDS new build sites. There will be a number of new dental centres constructed across the DDS estate in the coming years based on this new template and the ergonomic example of best practice seen here at DISC Chicksands.’

Equipment

The beauty of the setup is that it is scalable; it has been a success at DISC Chicksands and can be adapted to larger facilities too.

Dental treatment room

The renowned A-dec 500 dental operating unit was used in the treatment rooms because of its ambidextrous capabilities and its proven hardwearing track record. The dental equipment includes a high specification unit, ideal for the varying needs of the armed services. A-dec Solutions style cabinetry has been utilised in the treatment rooms, being adapted to the specific needs of the DDS, the cabinetry and the treatment rooms themselves have been designed to ensure all the equipment, instruments and materials are available and easily at hand.

New way of working

The design is very different from that previously used within the DDS, moving away from the standard L shape surgeries with their unnecessary storage units.

The decontamination areas are off limits to patients, but they are set up to supply the treatment rooms through an innovative instrument and materials management system.

Storage opportunities in the treatment room have been reduced, moving all but the essential consumable items out of the treatment room and into a central storage location. This new storage management system ensures almost all clinical stock is held centrally. So at a glance, the practice managers and their teams have a better understanding of stock levels, providing greater financial and stock control within the dental centres.

Decontamination centre

At Chicksands the new decontamination centre is state-of-the-art with separate dirty and clean rooms and a clever hatch to pass instruments from dirty to clean, using a second pass through unit the sterilised instruments and trays are placed directly into the storage room from the clean decontamination room.

Dirty side of the decontamination room

Clean side of the decontamination room

The clinical storage room has been designed to allow the instrument trays and materials tubs to be packed, checked and stored in appropriate units, from where the nursing team can deliver the right tubs and trays to the right treatment room for the right time.

Treatment rooms

Each treatment room has a pass through cabinet at the head of the dental chair passing into the staff only corridor, which leads to the decontamination rooms and the clinical storage room. This pass through unit should hold the necessary instrument trays and materials tubs for the various procedures that will be expected in the treatment room for each clinical session. This can be updated, amended and re-stocked throughout the day, depending on the coming procedures. The benefit of this system is that it ensures only the items that will be required for each session are taken out of the stock location and that any member of the team can clearly see, check and restock the items within the pass through, without interrupting the procedure taking place in the treatment rooms itself, all is done from the corridor side of the pass through. Any items and trays considered ‘dirty’ can be removed by the dental nurse at the end of each session directly to the decontamination unit, whereby it can be processed with other trays and instruments.

Each treatment room, has two doors that lead out into the decontamination corridor, one door for each of the operators, ensuring ease of access for both the dental nurse and dentist.

The treatment rooms at DISC Chicksands have an increased ceiling height, giving a sense of relaxation and space, with increased natural light through large high level windows, the aim is to engineer as much natural light as possible into all MoD new build dental centres. This is vital to ensure the correct lighting levels within the treatment room and to reduce unnecessary strain on the eyes of the hard working armed forces dental professionals.

Conclusions

Feedback from the clinical team has been very positive. Group Captain Marguerite Reith, principal dental officer for the east Midlands and East Anglia region said: ‘Our staff felt extremely supported throughout the process, particularly when it came to training on the new equipment. Attention to detail and quality was evident throughout the project. We had the sense that A-dec staff were personally involved in the success of the project and very keen to meet our specific requirements. There was a real ‘can do’ attitude and an ability to creatively solve any specific problems that were encountered. Other contractors on site also spoke highly of A-dec personnel and they were clearly respected for their professionalism and industry expertise. The relationship we have built with the A-dec team during this project has been positive and fruitful. There was a clear drive and commitment on their part to ensure the success of the project and there was an obvious sense of pride in their work. I am also confident that the excellent support offered will be provided in the longer term. Users are very impressed with the quality and ease of use of the equipment and there have been many unprompted comments attesting to this. I would be extremely optimistic that any future projects for the MoD will continue to build on the success of Chicksands.’

Anyone can design anything given a blank slate. But the key to success here was to take the existing guidelines, develop and maintain best practice, remain within budget and ensure the future-proofing of the centre. Christopher Cox of A-dec has done this to spectacular effect and for the benefit of our armed forces.

Chicksands officially opened by group captain MP Hart, Commandant DISC Chicksands and Brigadier N M Young QHDS, chief dental officer (defence)

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