Friday, December 15, 2017

A Quality Improvement Director Goes to the Forum...

This week, staff from DentaQuest’s Institute attended the 2017 Institute for Healthcare Improvement (IHI) Forum. During this multi-day conference, healthcare professionals from around the globe meet in Orlando to talk healthcare improvement. While oral healthcare is not a prominent discussion topic, DentaQuest has been attending since 2011. 

At Monday's pre-conference Scientific Symposium, Dr. Natalia Chalmers and Quality Improvement Project Manager Carrie Peltier presented a poster on our Dental Caries Management (DCM) Collaborative results (pictured left). Over 200 posters were submitted for consideration; the Institute’s poster was one of 70 - and the only one on oral health - chosen. Dr. Chalmers commented that the buzz about the importance of good oral health being vital to overall health was inspiring. Many wanted to learn more about the DentaQuest approach.

The general session featured a series of keynotes and 200+ workshops topics covering improvement science, joy in work, leadership, population health, person-centered care, safety, moving from volume to value to name a few. 

This year’s Forum opened from the lens of patient experience. The keynotes challenged care teams to create a bidirectional transfer of knowledge between patient and care team; this is, in fact, an act of caring. Care teams must work to create this space. It truly matters. Keynote Tiffany Christensen commented: we must ask generous questions to know and learn what matters to our patients. Our job is to make sure there is equity. These sentiments very much resonate with the Institute.

Later in the afternoon, we heard from Bryan Stevenson, a social justice advocate. Mr. Stevenson powerfully reminded us that it is our duty to create healthier communities. We must get closer to the poor and to communities that have been marginalized, neglected, and isolated. There is power in proximity. We also need to change the narrative that defines the difference of race. We must stay hopeful, as our hope has to fuel our practice. And lastly, we need to do the things that are uncomfortable. We have to make the choice to do the difficult thing.

General Stanley McChrystal shared his Team of Teams vision. He spoke about organizational change; being at an inflexion point and ready. He talked about ‘shared consciousness,’ meaning to connect on something with purpose and time and focus. “Together we need to project 'this place' where we want to go and make it to fruition.” This requires leadership that composes self-awareness, discipline, decision making, effective communication, connection, constant learning and functional excellence.

Lastly, as is IHI tradition, we heard from Dr. Don Berwick, president emeritus and senior fellow at IHI. Dr. Berwick’s spot-on remarks and reflections on the American healthcare system ring true year after year, and this year was no different. He shared a moving personal story of needing - and using - the healthcare system for his own family. He charged organizations to “snuggle,” meaning outline a clear and common purpose, be all together, or none at all and provide a safe vessel – failures are instructive; it’s OK to try, there can be shared honor, and we must have affection and mutuality. As this culture is what saved his brother.

Healthcare is complex; like the organizations who provide care and coverage. Inter-organizational competition is not the answer; coordination is. And DentaQuest is no different. Leaving this year’s Forum, I couldn’t help but board my plane back to Boston with some puffed feathers … DentaQuest has these pieces. We are prime to be the ‘Leading Voice.’ Improvement work is a social thing. It asks us to reflect, to adjust, to learn from, and to collaborate. It demands that we ask is what we are doing better or more of the same? We want better; we want to improve the oral health for all. That means understanding the system, at the macro, meso and micro levels. All together, or none at all. We must always ask “what do we want to learn over time?” and chart that course.


Cheers to another amazing Forum. Kaiser Permanente sent over 400 staff this year. Won’t you consider joining us next December in Orlando? This stuff matters!

----

Cindy Hannon, MSW
Quality Improvement Director 
DentaQuest Institute  
"When you believe in this stuff, it is easy to write!"



Thursday, November 16, 2017

Reaffirming our commitment to oral health in rural America

As rural stakeholders from around the country take time today to celebrate Nov. 16th as National Rural Health Day, DentaQuest reaffirms its commitment to improving the oral health of residents living in rural communities. DentaQuest Institute and DentaQuest Foundation have been involved in multiple activities and initiatives in recent years that help to improve oral health access and quality of oral health care for our nation’s rural residents. 


A few of the highlights include:
  • The Institute’s Medical Oral Expanded Care (MORE Care) Initiative, which focuses on the integration of oral health care into the rural primary care practice as well as the development of coordinated care networks with community dental providers, has assisted more than 20 rural primary care practices and dental providers in South Carolina, Pennsylvania, and Colorado. Based on learnings from the MORE Care initiatives in the three states, several publications were created to spread resources and knowledge to other rural communities interested in creating rural interprofessional oral health networks.
      • Rural Practice Guide – Released today – that provides practice-level guidance and practical how-to tips for rural health clinics interested in creating interprofessional oral health networks in their community: http://bit.ly/2AQ0LmR 

  • The Foundation’s support of the National Rural Health Association has enabled community health workers and other providers in Texas to be trained to integrate oral health into their outreach to residents living in colonias, Hispanic-populated communities along the U.S.-Mexico border.
  • DentaQuest Foundation grantee National Conference of State Legislatures is educating policymakers on issues that challenge rural communities in their access to oral health care, developing and publishing resources that can be found on their website, here.


For more information on these and other great projects being led by our Institute and Foundation teams, please visit the websites at www.dentaquestinstitute.org and www.dentaquestfoundation.org. You can also sign up for Socious, our Foundation’s online collaborative platform, to access resources and tools generated by our grantees and partners. Register here: www.oralhealth.network




Tuesday, November 7, 2017

Oral Health 2020 is helping unify and empower community voices

Hear from so many passionate individuals who are part of the DentaQuest Foundation's Oral Health 2020 National Network, which is working to address oral health equity, policy, and ultimately improved oral health for all.




Learn more about the movement: http://dentaquestfoundation.org/oh2020



Friday, October 27, 2017

Q&A: Dental Hygienist Opens Up for National Dental Hygiene Month

As October comes to an end, so does the national observance recognizing the need and importance of dental hygiene. For this Q&A, one of our own registered dental hygienists (RDHs) opens up about how she came to this career path and why it is invaluable to the oral health care system.

Let's dig in with Laura Skaret, RDH, BSDH | Project Manager, Safety Net Solutions | DentaQuest Institute

Q: Why did you decide to become an RDH?


A: My mom is a dental hygienist, and I got my first job at her office as a dental receptionist and then later was trained on the job to work as a dental assistant. I loved my experience as an assistant and found the work we did fascinating – including the devastating results of dental disease. I saw the cycle of dental disease first hand:  teeth would need small restorations, then larger restorations, then root canals, then crowns, and even sometimes implants. I knew I wanted to focus my career on helping patients prevent and properly manage dental disease rather than repairing the damage after it occurs.

We had a pamphlet in the office that said that enamel was far more valuable than gold (referring to a gold crown).  I found that to be such a thought-provoking and accurate concept.  It’s also similar to the old familiar adage, “an ounce of prevention is worth a pound of cure.”  That couldn’t be more true in the dental field.

Q: Why are hygienists important in the care team? 


A: Dental hygienists are patient advocates. When explaining the dental disease process to patients, I always tell them that my job is essentially to keep them out of the dentist’s chair, but I can only do so much without their buy-in.  Due to the nature of plaque biofilm, the daily care that patients do for their own mouths is far more important than the work that we do in one hour with them at the dental office. Patients go to the dental office maybe two to four times per year, however 365 days a year they are responsible for managing their own oral health.  This means our most important role is to educate and motivate our patients to improve their daily oral health habits. 

Q: What has been your greatest accomplishment or most proud moment in relation to working as an RDH?


A: I’ve realized that it’s not only what you do, but the way that you do it that can make an impact.  I always try to be very kind and compassionate to the questions and concerns of my patients. I’ve had several patients who were terrified of coming to the dental office when I first met them. Years of neglecting their mouths and avoiding the dentist would bring them to our office in a lot of pain and in need of quite a bit of dental work. In addition to using a gentle technique and local and topical anesthetics, I try to help them feel more comfortable by talking them through everything I’m doing or telling them stories to get their mind off of the situation. Sometimes it’s helpful to listen to their story to find out why they have a fear, affirm their past concern, and then assure them that won’t happen today. 

When those patients then continue to come in regularly, you know you’ve not only made a difference for their oral cavity, but for their life as well.  I had one patient who needed lengthy measures to address advanced decay and periodontal (gum) disease.  After we completed her first three visits of needed periodontal therapy, she actually sent a card to my office to thank me for helping her overcome her fear of the dentist.  With a more manageable level of fear, she was able to get the care she needed to restore her smile, which gave her back her confidence.

Q: How does your professional background impact/influence/help you in your DentaQuest Institute (DQI) role?


A: My primary role at DQI is as a project manager for Safety Net Solutions (SNS), a DentaQuest Institute program. Safety Net Solutions helps safety net dental clinics adopt targeted business management best practices.  Our focus is to ensure that these dental offices can maintain financial viability to stay open and provide access to care for the underserved. We also help ensure that they understand their capacity and can maximize access to care by optimizing their productivity.  

My previous experience of working in all areas of the dental office (receptionist, chairside with the dentist, and then also as a hygienist) means I have very comprehensive knowledge of how dental offices work, from scheduling appointments, to managing supplies and inventory, to managing the patient’s care experience, to dealing with dental equipment and instrument shortages. Basically, I can understand and relate to almost any concerns our SNS clients have.

Q: Why do you continue private practice once a week? 


A: Although you can technically keep your annual dental hygiene license “active” by simply paying the license fee each year, I want to keep it active with actual patient care, as well. Also I continue to practice because I love the work!  I love working with patients and helping them improve their oral health. I also believe this helps me stay relevant and engaged with my SNS clients and their common concerns. 

Q: What is one message you hope to impart to anyone interested in becoming an RDH?


A: Hygienists are super important members of the care team! As policy changes and we move forward with accountable care organizations and pay for performance insurance reimbursement models, I think the role dental hygienists play in preventing and managing disease will be brought even more into the forefront. When finances are attached to healthy patient outcomes, dental care teams will attach an even higher value to dental hygienists. 

Also, there is a massive shortage of dental professionals – and dentists in particular – nationwide. Maximizing the use of preventive modalities such as sealants, fluoride varnish, and silver diamine fluoride will help address access gaps where dentists are hard to come by, like rural areas.  Of course, we will never stop needing the education and skills of a dentist, but if we can reduce the demand for the skills of a dentist by reducing the dental disease burden, we can help minimize the gap in access to oral health care.  


Interested in learning more about prevention-focused dental care? Check out the DentaQuest Institute's Online Learning Center and let us know what you think! 





Thursday, October 19, 2017

Lunch Box oral health education program expands to kids with vision impairment

You may know that our mission is to improve the oral health of all, and starting with young children and health literacy is a great step forward.

Before this school year started, we supported efforts by The Children's Oral Health Institute to grow their national Lessons In A Lunch Box: Healthy Teeth Essentials & Facts About Snacks® program. This expansion enables the program to reach children who have impaired or loss of vision. Everyone needs to care for their mouths in order to have healthy futures, and Lunch Box is ensuring all kids have this chance.

In February, special lunchboxes - now with braille - will be delivered to participating schools along with a volunteer presentation to run the program.

So what is this educational program about healthy teeth and why does it matter? 

The Children's Oral Health Institute, a nonprofit based in Maryland, outlines it clearly:

  • Lessons In A Lunch Box: Healthy Teeth Essentials & Facts About Snacks is an educational oral health literacy program developed around a lunch box designed exclusively to teach elementary school children. The lunch box includes a color coordinated carrot case with a rinse cup top designed to store a toothbrush, toothpaste, and dental floss.
  • The program is created to help children to begin learning early, throughout grade school, about taking care of their teeth, making good diet choices and careers in dentistry.
  • The Children’s Oral Health Institute believes the program and the exclusive lesson guides, including the Code Red: The Oral Health Crisis In Your Classroom booklet, will encourage teachers to incorporate oral health education as a part of classroom instruction.
  • The program model is presented is to elementary schools with support from organized dentistry, local dental school faculty, their students and community volunteers. It is important that dentist examine and provide treatment for underserved children.
  • Exposing dental students to programs like Lessons In A Lunch Box may help to improve the access to the oral health care challenges we face throughout the country.
  • Further, the profession of dental medicine is facing a workforce shortage. According to the 2000 Surgeon General’s Report, by 2020 there will be one dentist for every 100,000 Americans. The program places emphasis on encouraging children to begin considering the dental profession as a career option. 
  • The ideal times during the school year to introduce the Lessons In A Lunch Box program are:
    • October, National Dental Hygiene Month. This is a good time of the school year to present the program because it allows the teacher approximately 8 school months to refer to the visual and practical lessons offered by lunch box.
    • February, National Children’s Dental Health Month (NCDHM). This is another great time because much of the dental community looks forward to participating in initiatives that highlight and support the annual observance of NCDHM when dental and medical professionals focus on efforts to improve the oral health of children.
    • Give Kids A Smile® (GKAS) Day. Usually celebrated throughout the country in late January or early February, GKAS is the annual centerpiece NCDHM.
  • The cafeteria has proven to be the best location in the school to present the program. Students can comfortably have their lunch box open in front of them while listening to the presenter explain all of the fun and exciting educational features of the delightful container. They learn about the following:
    • flossing, brushing and fluoride
    • healthy dietary choices and good eating habits
    • careers in dentistry
Did you learn anything new here? By partnering and supporting this expansion, we learned a lot about the vision impaired community and successful ways to help all children develop important oral health habits.



Tuesday, September 26, 2017

Hispanic Heritage Month: Highlighting two organizations committed to oral health

As part of our commitment to meeting the different oral health needs for different populations, DentaQuest learns about cultural heritage through observances like Hispanic Heritage Month, which runs through Oct. 15. It is a month-long tribute to Hispanic Americans who have so richly contributed to our society, and to the cultures, languages, and traditions passed down by their ancestors. DentaQuest is committed to improving health equity and advancing solutions that meet the needs of the many different people our plans and services touch, in part by supporting the efforts of local organizations.

While the contributions of our Oral Health 2020 network partners are as diverse as the communities and the perspectives they represent, and impactful in so many important ways, we’d like to take a moment to acknowledge two of our grantees who are working in this way to improve the public’s perception of oral health, and bringing the voice of Hispanic and Latino* communities to the table.

We know that the only way to develop targeted solutions and ultimately achieve better oral health for all is to engage those people who are most impacted. One of the goals of Oral Health 2020 is to improve the public’s perception of the value of oral health. We want everyone, not just dentists and hygienists, to recognize and understand the importance of the health of the mouth to the health of the rest of the body. With this important understanding, we will continue to mobilize communities across the country to rally together to advocate for better oral health.

In California, Vision y Compromiso is committed to improving community well-being by supporting promotores (liaisons between their communities and health and social service providers) and community health workers. Across 24 counties from Southern California to the Greater Bay Area, Vision y Compromiso’s network of promotores and community health workers is serving as a bridge for both native-born and immigrant people, and leveraging their shared language, ethnicity, culture, and experiences to reduce barriers to care and education. 

For example, together with Asian Americans Advancing Justice, Vision y Compromiso is spreading a campaign to educate individuals and families in the state on the health coverage available to anyone in the state, regardless of income or immigration status.  In just under two weeks, Vision y Compromiso will be bringing together these important stakeholders at their annual conference in Ontario, CA.

Also working on the West Coast is Latino Coalition for a Healthy California (LCHC). LCHC is one of the leading voices for Latino health in California, with a focus on initiating and advancing policies that help build healthy communities. With their ongoing work to address disparities in oral health, LCHC is focusing efforts on ensuring that affordable dental care is accessible to all Californians. 

Like Vision y Compromiso, LCHS is also working with promotores, training them to be both advocates and messengers for oral health and its social influences in Latino communities. LCHC is committed to elevating the voices of those in their communities to be heard by decision- and policymakers, in order to improve oral health at a systemic level. A recent initiative champions efforts that reduce access to sugar-sweetened beverages, which not only impact oral health, but also contribute to the disproportionately high incidence of diabetes in both adults and children in Latino communities.

We are so proud to support these and so many other amazing organizations that are working to improve the oral health of all. Please visit their websites to learn more:



*While “Hispanic” and “Latino” are often used and understood interchangeably, “Hispanic” focuses on Spanish-speaking origin, while “Latino” refers to people of Latin American origin.


Friday, September 8, 2017

Children's Health Insurance Program (CHIP) is vital for kids' wellbeing

September is a big month for kids – not only are they starting or heading back to school, but this year they also are taking center stage in Washington as Congress heads back from its own summer recess. Funding for the Children’s Health Insurance Program (CHIP) will expire at the end of September, meaning Congress must act swiftly to ensure continued, comprehensive medical and dental coverage for our nation’s children.

Nationwide, CHIP covers approximately 9 million uninsured kids (and in some cases, pregnant mothers) in families with incomes that are modest but too high to qualify for Medicaid. 

States administer the CHIP program in different ways. Your state may have a separate CHIP program, combine the CHIP and Medicaid programs, or include CHIP within Medicaid expansion initiatives. Although administered by states in a variety of ways, the federal government provides matching federal funds to all states and that funding is vital to the program’s continued success.

Historically, CHIP reauthorization and funding have enjoyed bipartisan support, with members of Congress working together to guarantee health care coverage for vulnerable children. However, with the hotly-contested debates over Affordable Care Act repeal and replace legislation, securing the future of the CHIP program may prove significantly more challenging this time around…

Congress must tackle a significant number of important issues in short order this September. 


Addressing the debt ceiling to avoid a government shutdown, authorizing Hurricane Harvey relief, and handling a Trump administration proposal to privatize air traffic control are all at the top of the list. But Congress cannot lose sight the importance of CHIP. 

Without a long-term solution, states will be left with uncertainty over the future of their health care programs for kids. If CHIP funding is not renewed, or not renewed by the end of the month, states will be forced to make difficult decisions regarding the enrollment of the children in their programs. Without this funding, some children will be left without any form of medical or dental coverage.

We have seen over time that coverage leads to care and access to appropriate dental care is vital for children. In particular, tooth decay, the most common chronic disease among children, is degenerative without treatment and prevention, and research shows poor oral health impacts school performance and attendance.

But CHIP’s importance extends beyond oral health. 


For example, recent research indicates that treatment of gum disease can lead to better overall health management—as evidenced by lower health care costs and fewer hospitalizations—among people with common health conditions, such as type 2 diabetes. Ultimately, Congress must understand the gravity of their decision – coverage for children positions them well for a lifetime of optimal health and success. Don’t let politics put this at risk. Instead, let’s collaborate across party lines to quickly develop a sustainable plan that provides effective coverage for children and mothers in CHIP.

September 2017 marks the start of school and the start of what could make or break our children’s futures. This month is about ensuring our next generation is well-positioned to achieve optimal health throughout their lifetimes. As an organization committed to improving the oral health of all, DentaQuest strongly urges Congress to work together on CHIP funding and reauthorization in time to protect these vulnerable populations.


Make sure your voice is heard! 


Look up your Representative or Senator and ask them to renew CHIP funding and support long-term, sustainable solutions to protect our children’s health care.