Retrospective assessment of an intentional interprofessional experiential education experience involving pharmacy students in a dental clinic.

BACKGROUND: Our objective was to create an intentional Interprofessional Education Experience (IEE) that satisfied the requirements set forth by the Center for the Advancement of Pharmacy Education (CAPE 2013), the Accreditation Council for Pharmacy Education (ACPE) Standard 11, and the Interprofessional Education Collaborative (IPEC) Competencies. These frameworks elevate the importance of interprofessional education in pharmacy. They not only guide educational standards but also emphasize the crucial role of collaborative healthcare practices in ensuring comprehensive patient care and improving health outcomes. Our evaluation of PharmD students' attainment of Interprofessional Education (IPE) learning outcomes employed both quantitative and qualitative assessment methods to provide a comprehensive understanding of their achievements. INTERPROFESSIONAL EDUCATION ACTIVITY: Fourteen PharmD students participated in an intentional IEE experience in a community dental clinic, collaborating with the dental clinic team and patients. Assessment methods combined quantitative data from SPICE-R2 with qualitative insights from daily reflections and an IPE Field Encounter based on IPEC Competencies. This approach ensured a thorough evaluation across individual experiences. DISCUSSION: Quantitative analysis revealed a statistically increase in mean scores for four out of ten questions on the SPICE-R2 instrument. Qualitative data analysis utilized grounded theory to analyze emerging themes. IMPLICATIONS: Employing both quantitative and qualitative assessment methods in this intentional IEE environment has proved beneficial in assessing IPE learning outcomes. The PharmD students were able to deliver patient-centered care as valuable members of an interprofessional healthcare team.

Clinical Integration in a Dental School Clinic Through an Enhanced Patient Intake Process.

Dental care in the U.S. is based on a general practice model of care delivery that can be enhanced by the integration of the dentists and allied dental professionals. There are 25 U.S. dental schools with associated dental hygiene programs, presenting distinctive opportunities for educating the dental health care team. Integrated educational clinical experiences are believed to positively influence teamwork and quality of care that parallels the authentic general practice environment. Lean management, developed by Toyota and used in a variety of types of organizations including health care, provides a distinctive blend of engineering principles and operations management to enhance business and operations processes. A fundamental principle of Lean management is the elimination of waste and preservation of only those value-added components of a process. The faculty and staff of The Ohio State University College of Dentistry, trained in Lean process improvement, applied techniques to enhance and integrate an inefficient patient intake (admissions) process. The aim of this initiative was to improve patient throughput in the patient intake process and to provide dental and dental hygiene students with enhanced educational experiences from improved clinical integration. These goals were achieved through streamlining patient flow and relocating major phases of the process. Although new patient retention and cancellation/no-show rates remained mostly unchanged, this enhancement project resulted in improved access to care, improved continuity of care, expanded scope of dental services offered, improved patient satisfaction, and enhanced dental and dental hygiene student collaboration and teamwork. These outcomes suggest that process improvement initiatives can serve as valuable opportunities for integration of the dental health care team.

A comparison of patient safety culture at two campuses of Riyadh based dental College.

OBJECTIVE: To identify potential shortcoming(s) in relevance to patient safety culture at dental clinics. METHODS: The cross-sectional study was conducted from March to June 2016 at two clinics of a dental teaching college in Riyadh, Saudi Arabia, and comprised subjects who had either direct or indirect contact with patients in the dental clinics. The subjects were handed over a questionnaire based on the Patient Safety Culture Hospital Questionnaire. SPSS 21 was used for data analysis. RESULTS: Of the 149 subjects, 96(64.4%) were male, and 130(87%) were in direct contact with patients, while 19(13%) were in indirect contact. Overall, 52(35%) subjects stated that their unit did not have enough staff to handle the workload, and 71(47.7%) said that not encountering serious errors in their unit was pure luck. An encouraging finding was that 104(69.8%) subjects said their managers appreciated them when they followed the established patient safety protocol. Conclusion: There was a variation in the perception of patient safety culture among professionals.

Dog-assisted therapy in the dental clinic. Part B. Hazards and assessment of potential risks to the health and safety of the dental therapy dog.

Background: A dental therapy dog may help anxious patients in the dental clinic overcome their fear and facilitate the completion of necessary dental care. Dental clinic activities are associated with hazards that may pose potential risks to the health and safety of the dental therapy dog. Objectives: To describe potential hazards associated with risks to health and safety to therapy dogs in dental clinics and to present suggestions for risk minimisation by adopting best practices in dental clinic settings. Materials and method: Literature searches in Medline, http://Clinicaltrials.gov, and Google Scholar for qualitative and quantitative assessments of occupational hazards and risks in dental clinics, in combination with a review of the reference list of the included studies. Identified hazards and risks were analysed relative to their relevance for the health and welfare of a therapy dog present in a dental clinic setting. Results: Workplace hazards in the dental clinic that apply to both humans and therapy dogs are allergies, sharps injury, eye injury, stress, rhinitis, hearing impairment, and other hazards. Additional concerns associated with risks for the dental therapy dog are situations involving erratic patient behaviour and threats if the patient is an undisclosed disease carrier. Risks to the health and safety of the dental therapy dog in the clinics are present but are low if the dental clinical staff and dog handlers comply with best practices. Conclusions: Best practice includes awareness amongst the clinic staff and the dog handler of all potential hazards in the dental clinic and on how to reduce these hazards as well as adverse events that may scare the dental therapy dog. The dental therapy dog team must be specially trained to work in a dental clinic. Each treatment session has to be exclusively tailored to that specific appointment and the individual patient.

Dog-assisted therapy in the dental clinic: Part A-Hazards and assessment of potential risks to the health and safety of humans.

Background: Dog-assisted therapy in the dental clinic may be an attractive alternative to sedation for anxious patients. Including a dental therapy dog in a clinical setting introduces new hazards and potential risks to health and safety for both humans and animal. Objectives: The study aims to describe potential hazards associated with risks to humans by having a therapy dog present in the dental clinic and to provide guidance on best practices to minimise and control risks for the patients, the dentist, and the dental clinic staff. Materials and Methods: Literature searches in Medline, http://Clinicaltrials.gov, and Google Scholar for qualitative and quantitative assessments of hazards and risks associated with the use of therapy dogs in health care settings, in combination with a review of the reference list of the included studies. Identified hazards and risks were analysed with respect for the health and welfare of humans in a dental clinic setting that involves the presence of a therapy dog. Results: Potential risks to health and safety for humans in dental clinics that offer dog-assisted therapy can be categorised within four general categories of hazards: the dog as a source of zoonotic pathogens and human diseases, exposure to canine allergens, adverse animal behaviour, and dangers associated with high activity in a congested dental clinic operatory. Risks to humans are reduced by maintaining awareness amongst the dental clinic staff and the dog handler of all potential hazards in the dental clinic, and on how to reduce these hazards as well as adverse events that may scare the dental therapy dog. Conclusions: Risks to the health and safety of humans in the presence of therapy dog in the clinics are present but are low if the dental clinical staff and dog handlers comply with best practices.

Dental Quality Measurement--A Practitioner Perspective.

This article reviews the HealthPartners Dental Group's experience with clinical quality measurement and provides information on the administrative infrastructure that supports measurement within the group. Some examples of the role measurement plays in operations and clinical practice are also reviewed.

Assessment of volatile organic compounds and particulate matter in a dental clinic and health risks to clinic personnel.

This study was conducted to assess (1) levels of volatile organic compounds (VOCs) and particulate matter (PM) in a dental clinic in southern Taiwan and (2) dental care personnel's health risks associated with due to chronic exposure to VOCs. An automatic, continuous sampling system and a multi-gas monitor were employed to quantify the air pollutants, along with environmental comfort factors, including temperature, CO2, and relative humidity at six sampling sites in the clinic over eight days. Specific VOC compounds were identified and their concentrations were quantified. Both non-carcinogenic and carcinogenic VOC compounds were assessed based on the US Environmental Protection Agency's Principles of Health Risk Assessment in terms of whether those indoor air pollutants increased health risks for the full-time dental care professionals at the clinic. Increased levels of VOCs were recorded during business hours and exceeded limits recommended by the Taiwan Environmental Protection Agency. A total of 68 VOC compounds were identified in the study area. Methylene methacrylate (2.8 ppm) and acetone (0.176 ppm) were the only two non-carcinogenic compounds that posed increased risks for human health, yielding hazard indexes of 16.4 and 4.1, respectively. None of the carcinogenic compounds increased cancer risk. All detected PM10 levels ranged from 20 to 150 µg/m(3), which met the Taiwan EPA and international limits. The average PM10 level during business hours was significantly higher than that during non-business hours (P = 0.04). Improved ventilation capacity in the air conditioning system was recommended to reduce VOCs and PM levels.

Factors affecting patient satisfaction at the Lagos State University Teaching Hospital Dental Clinic.

BACKGROUND: Satisfaction is important in dental care because satisfaction with care alleviates dental anxiety, influences patients' compliance and is an important indicator of quality of care. OBJECTIVES: This study was designed to determine the factors that contribute to satisfaction with dental care among patients attending the Lagos State University (LASUTH) Dental Clinic. METHODS: Across-sectional, descriptive questionnaire-based survey was conducted among adult patients attending the LASUTH Dental Clinic. The questionnaire, a modification of the Dental Satisfaction Questionnaire (DSQ), contained 19 items on a Likert-pattern scale with scores ranging from 0 to 4. RESULTS: The scores obtained for satisfaction with the dental services ranged from 19 to 75 with a mean of 55.30 +/- 11.55. The majority of respondents (305 or 87.4%) were satisfied with the services received. The items generating the highest and lowest mean satisfaction score were cleanliness/comfort of the facility and cost of services respectively. Long waiting time was the item respondents liked least about the services. There was a statistically significant relationship between the items assessing communication and respondent's gender (p = 0.001). The relationship between the overall satisfaction score and gender (p = 0.233), age category (p = 0.842) and educational status (p = 0.565) were not statistically significant. CONCLUSION: The results indicate a high level of satisfaction with services provided at the LASUTH Dental Clinic. However, there is need for improvement in communication with patients and reduction in waiting time.

An assessment of the quality of care provided to orthognathic surgery patients through a multidisciplinary clinic.

The quality of care delivered to 74 patients undergoing orthognathic surgery was assessed using a patient satisfaction questionnaire and data collected from hospital case records. Surgical complications, hospital services, patient satisfaction, and impact on quality of life, were the main aspects considered. The majority of patients reported that their treatment objectives had been achieved and that they were satisfied with the quality of care provided. The main concern of the patients regarding the clinic was the waiting time before an appointment could be offered. Eating and breathing difficulties and low mood after surgery were the main reported complications. Sixty-three patients experienced post-operative weight loss. The importance of a nutritious, high calorie soft diet should be emphasised and the use of menthol inhalations following maxillary osteotomies should be considered more frequently. Clinicians should be aware of post-operative low mood, which may require psychological support. We developed a sensitive assessment battery with comprehensive parameters to audit quality of orthognathic surgery service, and recommend that a similar approach should be considered by teams which undertake management of orthognathic patients.

Patient satisfaction: a survey of dental outpatients at the Lagos University Teaching Hospital, Nigeria.

BACKGROUND: Patient satisfaction with dental services has received minimal attention in Nigeria. Quality of service is however, an integral part of any business. The study assessed dental outpatients' satisfaction with oral health care delivery a tertiary institution in Nigeria. The perceptions of the oral health care provider and suggestions that will improve service delivery were also obtained from these consumers. METHODS: A modified Dental Satisfaction Questionnaire (DSQ) was used to assess the patients. An aggregate score was also calculated for each respondent for all variables tested under the five items on dental patient satisfaction. The highest possible score was 76, based on the number of items assessed. The cut off point for satisfaction was set at 38. RESULTS: Three hundred patients participated in the study. The items with the top three scores were dentist-patient relationship (respect/listen), rapport and infection control with mean scores of 3.5, 3.4, and 3.3 respectively. The range for the aggregate score for level of satisfaction was 16-68. High level of satisfaction reported in 159 (53%) of the respondents and low level in 141 (47%). Dissatisfaction was expressed with regards to the infrastructure, electricity/regular supply of water and being treated by unsupervised students in 85.7%, 59.5% and 89% respectively. CONCLUSIONS: The overall high level of satisfaction was related to the communication skills and rapport of staff with the patients. There is an urgent need for improvement on infrastructure and provision of a steady supply of water and electricity.

The introduction of a new assessment system in restorative dentistry: the undergraduate and patient experience.

In 2000, the University of Bristol Dental School Division of Restorative Dentistry carried out a review of the assessment methods used within the undergraduate programme. Following this review, a number of key recommendations were made and the system of formative assessment within the division was changed. Audits were conducted immediately prior to the introduction of the new system and 2 years after it had been introduced, the results of these audits are presented. There was no change in the number of failed appointments between the initial audit and the second audit. There was a reduction in the number of patients treated by more than one student from 25% to 14% (approximating to 3% if student withdrawal from the course is taken into account). The length of time taken to complete treatment reduced between the two audits with more than half of all patients having their treatment completed within 3 months of their initial examination in the second audit. Ninety-five percent of treatment plans were completed in the second audit compared with only 62% in the first audit. In the second audit, the outstanding 5% of cases were signed off as incomplete for satisfactory reasons by the member of supervisory staff (e.g. patients who had moved away or were discharged due to poor attendance). Student comments were mostly positive, the small number of negative comments related to some students being confused by the paperwork in the new system. The overall process has been an extremely positive experience which has resulted in an assessment system with increased clarity which appears to have reduced the stress levels reported by the undergraduate students on the programme and improved the quality of patient care within restorative dentistry.

Factores asociados al nivel de apego terapéutico en niños con tratamiento estomatológico prolongado en la Clínica Reforma / Factors associated with the therapeutic attachment level in children under prolonged dental treatment at the Reforma Clinic

Antecedentes: en al ámbito odontológico son pocos los estudios realizados que han idnetificado los factores asociados al apego terapéutico. Objetivo: identificar los principales factores que influyen en la adherencia terapéutica en niños con tratamiento estomatológico prolongado. Método: se trata de un estudio observacional, prolectivo, transversal y descriptivo. La muestra está formada por 30 pacientes que acudieron a la Clínica Multidisciplinaria Reforma de la UNAM y que fueron atendidos por los alumnos de la especialidad en Estomatología para el Niño y el Adolescente. Instrumento empleado, cuestionario. Resultados: se identificó el factor económico como el principal para el desapego terapéutico. Conclusiones: en enfermedades crónicas como la caries y las maloclusiones el porcentaje de desapego terapéutico es del 50 por ciento

Clinical assessment of orthodontic outcomes with the peer assessment rating, discrepancy index, objective grading system, and comprehensive clinical assessment.

PURPOSE: The purpose of this study was to quantitatively assess orthodontic treatment outcomes in postgraduate orthodontic clinics at Okayama University (OU) and Indiana University (IU). MATERIAL: Using the peer assessment rating (PAR) index, the discrepancy index (DI), the American Board of Orthodontist's objective grading system (OGS), and the comprehensive clinical assessment (CCA), we evaluated pretreatment and posttreatment records of 72 patients from OU and 54 patients from IU. RESULTS: The average pretreatment PAR score with United Kingdom weighting was 32 for OU subjects and 28 for IU subjects. Differences in maxillary and mandibular buccal alignment between schools were statistically significant ( P < .01). The posttreatment PAR scores were 7 for OU and 4 for IU. The difference in overjet between schools was statistically significant ( P < .05). The mean DI scores were 19 for OU and 17 for IU. OU patients scored significantly more DI points for crowding and mandibular plane angle compared with IU patients ( P < .05). On the other hand, they lost significantly fewer DI points for overbite and occlusion compared with IU patients ( P < .05). The mean OGS scores were 34 for OU and 33 for IU. Buccolingual inclination and overjet scores were significantly higher in OU patients compared with IU ( P < .05). The mean CCA score was approximately 4 points for both OU and IU. CONCLUSIONS: These data suggest that these indexes are useful for comparing treatment outcomes between clinics. They were able to identify specific problems in treating Asian patients.

Experience of 2 dental clinics registered to ISO 9002.

This paper describes the 3-year experience of managing 2 hospital-based dental clinics registered to ISO 9002:1994; it also examines the revision of previous quality management standards in 2 separate institutions to prepare for registration under the new ISO 9001:2000 standard. Daily equipment and process checks, combined with internal audits, were the backbone of the quality system at both locations. Corrective and protective actions had been underused, because of the partial duplication produced by 2 different institutionally mandated risk management and incident reporting systems. ISO 9002 registration provided both dental clinics with responsive quality systems, emphasizing patient satisfaction and providing measurable continuous quality improvement.

Patient management: measuring patients' expectations and perceptions of service quality in a dental training hospital.

The difference between service quality expectations and perceptions (experiences) of patients (customers) attending a dental training hospital was investigated by using a modified version of the Parasuraman SERVQUAL model. A questionnaire comprising 28 service quality-related statements and four open-ended questions was used at the interviews. The study showed that 11.6% of respondents experienced problems with the service. A principal component factor analysis indicated that two of the five dimensions of service quality, namely reliability and assurance, contributed to 59% of service level variance. Female patients showed larger mean differences than male patients. The greater the number of visits to the hospital, the smaller the difference between expectations and perceptions. Patients in the category 36-45 years of age, showed larger mean differences than younger or older patients. Respondents with no academic qualifications had lower expectations of the service, while professional people seemed to have more realistic expectations prior to a visit to the hospital than respondents in the technical/clerical category.

A comparison of patient satisfaction among current and former dental school patients.

Patient satisfaction is becoming an increasingly important indicator of quality dental care. However, most patient satisfaction surveys target only the current patients of the dental practice or institution, which may give an inflated estimate of satisfaction with care, since dissatisfied patients are likely to have left the practice or institution. The purpose of this study was to compare the satisfaction of three categories of dental school patients with several aspects of care received at the school. Data were collected using a telephone survey of 291 patients, systematically selected from the dental school's computer listings of all current, recall, and former patients. The survey instrument sought information about why respondents came to the school for dental treatment, why respondents who were no longer in treatment had dropped out of care, and respondents' opinions on eleven aspects of quality of care provided at the dental school. Dental students who had completed a training session served as interviewers. Results indicate that, overall, patient satisfaction with the care received was high, with none of the means for any category of patient falling into the dissatisfied range. Respondents who had dropped out of care were less satisfied than active or recall patients in five areas: quality of care, length and number of appointments, treatment explanation, and fees. Results have implications for dental school administrators and educators in their efforts to provide high quality patient care and to retain an adequate patient pool to ensure optimal clinical experiences for students.

Evaluation of audit-based performance measures for dental care plans.

OBJECTIVES: Although a set of clinical performance measures, i.e., a report card for dental plans, has been designed for use with administrative data, most plans do not have administrative data systems containing the data needed to calculate the measures. Therefore, we evaluated the use of a set of proxy clinical performance measures calculated from data obtained through chart audits. METHODS: Chart audits were conducted in seven dental programs--three public health clinics, two dental health maintenance organizations (DHMO), and two preferred provider organizations (PPO). In all instances audits were completed by clinical staff who had been trained using telephone consultation and a self-instructional audit manual. The performance measures were calculated for the seven programs, audit reliability was assessed in four programs, and for one program the audit-based proxy measures were compared to the measures calculated using administrative data. RESULTS: The audit-based measures were sensitive to known differences in program performance. The chart audit procedures yielded reasonably reliable data. However, missing data in patient charts rendered the calculation of some measures problematic--namely, caries and periodontal disease assessment and experience. Agreement between administrative and audit-based measures was good for most, but not all, measures in one program. CONCLUSIONS: The audit-based proxy measures represent a complex but feasible approach to the calculation of performance measures for those programs lacking robust administrative data systems. However, until charts contain more complete diagnostic information (i.e., periodontal charting and diagnostic codes or reason-for-treatment codes), accurate determination of these aspects of clinical performance will be difficult.

[Assessment of the indicators of organizational activities of dental polyclinics in Moscow]. / Ob otsenke pokazatelei organizatsionnoi deiatel'nosti stomatologicheskikh poliklinik Moskvy.

Presents the method of comprehensive probability assessment of a number of indexes calculated on the basis of the data derived from annual reports of 36 dental clinics of Moscow for 1994. Correlations between the indexes and their signal deviations from the mean values were assessed and their integration and ranging carried out. This confirmed the possibility of a more effective utilization of reported data in adopting the managerial solutions and improvement of the medical and technological process.

Dream busters ... clinic income.

In summary, the best clinical education occurs in a setting of exemplary patient care. The critical factor is quality--not just technical quality, but those features by which patients judge quality. Commitment to service should be enhanced and barriers should be minimized in order to achieve efficient and personalized patient care. And, schools must always reach for a higher standard, (9) exceeding their patients' expectations. As Pacific Bell Telephone says in its commercials: "Good enough isn't."