A late afternoon in the autumn of 2010, Bo Danielsen sat in his office at the University of Copenhagen where he had recently been appointed Head of the School of Oral Health Care. He was looking at the budget for the following year and felt a little bit uneasy despite everything being OK. The school and clinic were running smoothly, the budget was balanced and he felt rather confident that next year everything would run as smoothly as before. However Bo wanted staff to use their time on teaching students and have concern for the patients – value added activity rather than on spending time in the sterilization room and on making inventory reports and budget estimates. In addition Bo also wanted information regarding the use of instruments, their utilisation and turn over in the clinics for fact based decision making regarding the manpower assigned the sterilization room and the need for renewal of instruments.

Despite the impeccable work the team had done, they still didn’t know exactly how much money they needed to spend on purchasing new mouth mirrors, curettes and other dental hand instruments that would wear out the next year as a result of normal wear and tear and regular sharpening. Previously they had also estimated renewal of instruments on pure intuition rather than on facts. The wish was to estimate the number of extra instruments needed for compensating the fact that all instruments are not always in the right place at the right time and that at any given time, a number of instruments are in the autoclave, some are in other phases of the reprocessing cycle and some are worn out. The team knew that the demand for instruments varied from day to day depending on the amount of treatments scheduled for that particular day and on the type of clinical procedures of those treatments. The team also knew that the capacity of the reprocessing section varies somewhat.  Manning of the sterilization room and what to do when staff are sick is sometimes difficult when the need for capacity is not known in detail.

Bo knew that misplaced instruments was a wasteful hidden cost. Sometimes staff and students had to go from one operatory to the other to get an instrument that they had run out of. Not necessarily because there weren’t enough instruments but because the instruments were not in the right place at the right time. It is easy to disregard the time spent on this trivial task but every footstep taken in this situation is expensive. In addition to staff frustration and longer patient wait times, each footstep also means that the capital invested in the facilities and the dental delivery unit are running on idle and the time of the students is spent on something else than treating patients and learning. The cost per patient and cost per student was thus increased because of time wasted in inefficient processes. What annoyed Bo was that he didn’t know how big this impact on cost was and how much more could be done with the same resources if everything was optimized and the processes designed to help the staff and students do their jobs better.

Although everything was OK in the big picture, the tech savvy team in Copenhagen had never been complacent as far as continuous improvement goes. Previous brainstorming sessions had yielded ideas about how wireless tracking of instruments would change both how they did budgeting and how they ran daily operations at the clinic.

Five years later, on August 18^th 2015, Danielsen walked through the main entrance of the Panum building. He had walked through these doors every day since he started working at the University of Copenhagen but today, he was stepping into the world’s first dental clinic and school with an RFID-based (radio-frequency identification) wireless tracking system for dental instruments. Together with LM-Dental, a company based in Finland and a part of the largest privately owned dental conglomerate Planmeca, Bo Danielsen and his team had implemented what previously had only been an idea. Now every dental delivery unit at the School of Oral Health Care was equipped with a wireless RFID-reader and additional readers were placed e.g. next to the autoclave in the reprocessing room and in storage rooms that serve different parts of the clinic. Practically all instruments ranging from mouth mirrors and aspirating syringes to dental turbines and micromotor handpieces were equipped with a tiny, autoclavable RFID-tag that is read wirelessly in an instant without slowing down the daily routines at the clinic. When Bo sat down at his computer, he logged-in to the cloud based server, the brains of the LM-Dental Tracking System (DTS), which receives all the information from all the readers across the clinic. On his screen he could see where each and every instrument was and whether it was ready for clinical use or contaminated and awaiting reprocessing. The complete history of the specific instrument in question is also documented including e.g. the information about when it was autoclaved and by whom.