By Cindy Hannon,
Manager of Quality Improvement, DentaQuest Institute
The way that
healthcare is delivered to patients is undergoing significant change and dental
is no different. The Institute for Healthcare Improvement termed our new
healthcare goals the Triple
Aim: improving the patient experience of
care, improving the health of populations, and reducing the cost of
care. At the DentaQuest
Institute, we believe this is the future of care and are proud to have
created a model that is helping to meet the Triple Aim with our Early
Childhood Carries (ECC) Collaborative.
Early Childhood Carries is an aggressive form of dental
disease in very young children (1-5 years old). Often times, when the disease
is not treated early, children end up in hospital operating rooms for oral
surgery, which can involve anesthesia, root canals and stainless steel crowns.
This is a very scary, painful experience for young children; it places an
unnecessary strain on hospitals, especially given that dental disease is nearly
100 percent preventable.
We recognized that this method of care was just treating the
symptoms and not the cause. Nor was it preventing the disease from
recurring again; many children returned in a year with the same symptoms in
other teeth. So, partnering with dentists and their care teams at Boston
Children’s Hospital (BCH) and St. Joseph Hospital for Specialty Care in Rhode
Island (St. Joe’s), the DentaQuest Institute created the ECC Collaborative in
2008. We focused on teaching dental care providers and dental clinics how to
work with children and parents to prevent dental disease rather than
just treat it. Our goal has been, and is, to spread best practices about
preventive education and disease management to think differently about the way
we treat young and vulnerable patients before and after surgery. This disease
management protocol is, we believe, providing a more engaged caregiver
experience and this is helping improve patient and family outcomes, ie. better
oral health. This Collaborative is building evidence to meet the Triple Aim.
During the first phase of the program:
- Children participating in the ECC Collaborative reported a 50 percent decrease in pain.
- The number of children who did not develop additional disease after the initial treatment improved by 69 percent.
- Operating room utilization was reduced by 55 percent.
The ECC Collaborative has expanded considerably since 2008. In
2011, five community health centers and hospital-based dental clinics across
the country joined BCH and St. Joe’s for Phase II. The teams collected data
about disease risk, pain from untreated decay, and new cases of disease.
Each site focused on individual system changes, engaging and educating staff in
the importance of scheduling recall visits within the recommended timeframe,
educating care givers to think about possible behavior changes and helping them
set self-management goals for their child. Once again, we saw that disease
management and prevention improved outcomes, reduced disease, controlled cost
and kept the children’s mouths healthier.
You can learn more about the ECC Collaborative, what current
participants are doing and how to get involved. Watch our video.