Friday, September 2, 2016

Dental Health Care Needs Quality Improvement Now

The message couldn’t be clearer: The time for the dental profession to jump on the health care quality improvement (QI) bandwagon is now.

In the past quarter-century, the United States has seen medical care improve and per capita health care costs go down thanks to QI standards adapted from other industries like manufacturing. But why has the dental profession been so slow to join the game? Our recent DentaQuest Institute editorial in the July/August 2016 issue of Pediatric Dentistry provides some clues.

In our editorial, we argue that, because of QI’s effectiveness—in medicine and other fields—it is 
“...imperative that dental professionals create the culture and systems necessary to apply QI principles and activities for the benefit for our patients, the public at large, and our profession.” 

That may be easier said than done, but our own Dr. Natalia Chalmers, who heads DentaQuest Institute’s Analytics and Publication team, and her colleagues lay out a number of programs that place a heavy emphasis on QI - from DentaQuest Institute’s EarlyChildhood Caries (ECC) program and the UCLA-First 5 LA Oral Health Program to new initiatives from the American Dental Association’s Dental Quality Alliance. 

The common thread with these programs: they all work.

  • Through ECC Collaborative, an effort to reduce dental caries in young children, 32 federally-qualified health centers (FQHCs) significantly improved patient outcomes after implementing a disease-management approach to QI.
  • The UCLA program helped 22 local FQHCs redesign workflows based on QI models, improving diagnostic, preventive and treatment services in participating dental clinics. With the “triple aim” of improving patient experiences, improving health status, and lowering costs, the ADA’s Dental Quality Alliance seeks to help dental practices establish processes “to reliably deliver evidence-based care to every patient.”

The authors note small steps may be all that’s needed to push the profession toward QI. For example, the Plan-Do-Study-Act cycle results in a trial-and-error approach until performance improvements are realized. This practice has helped improve quality performance in industries from high-tech to higher education. There’s no reason dentistry can’t do the same.

They also understand that integrating QI into a dental practice requires considerable planning, coordination and commitment. And it takes a team for QI to take root. Dental practitioners, office staff and even patients must be invested in the process for it to work.

That said, dentists need to begin thinking now about QI at the practice level. These efforts will have an enormous impact on the way dental care is delivered. And, as the DentaQuest editorial illustrates, that’s a win-win for everyone.