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Hindi AMK, Campbell SM, Jacobs S, Schafheutle EI. Developing a quality framework for community pharmacy: a systematic review of international literature. BMJ Open 2024; 14:e079820. [PMID: 38365299 PMCID: PMC10875530 DOI: 10.1136/bmjopen-2023-079820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To identify the defining features of the quality of community pharmacy (CP) services and synthesise these into an evidence-based quality framework. DESIGN Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES International research evidence (2005 onwards) identified from six electronic databases (Embase, PubMed, Scopus, CINAHL, Web of Science and PsycINFO) was reviewed systematically from October 2022 to January 2023. Search terms related to 'community pharmacy' and 'quality'. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Titles and abstracts were screened against inclusion or exclusion criteria, followed by full-text screening by at least two authors. Qualitative, quantitative and mixed-method studies relevant to quality in CP were included. DATA EXTRACTION AND SYNTHESIS A narrative synthesis was undertaken. Following narrative synthesis, a patient and public involvement event was held to further refine the quality framework. RESULTS Following the title and abstract screening of 11 493 papers, a total of 81 studies (qualitative and quantitative) were included. Of the 81 included studies, 43 investigated quality dimensions and/or factors influencing CP service quality; 21 studies assessed patient satisfaction with and/or preferences for CP, and 17 studies reported the development and assessment of quality indicators, standards and guidelines for CPs, which can help define quality.The quality framework emerging from the global literature consisted of six dimensions: person-centred care, access, environment, safety, competence and integration within local healthcare systems. Quality was defined as having timely and physical access to personalised care in a suitable environment that is safe and effective, with staff competent in the dispensing process and pharmacy professionals possessing clinical knowledge and diagnostic skills to assess and advise patients relative to pharmacists' increasingly clinical roles. CONCLUSION The emerging framework could be used to measure and improve the quality of CP services. Further research and feasibility testing are needed to validate the framework according to the local healthcare context.
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Affiliation(s)
- Ali M K Hindi
- Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Stephen M Campbell
- Centre for Primary Care, University of Manchester, Manchester, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Sally Jacobs
- Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Ellen Ingrid Schafheutle
- Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
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Qin D, Hua F, John MT. GLOSSARY FOR DENTAL PATIENT-CENTERED OUTCOMES. J Evid Based Dent Pract 2024; 24:101951. [PMID: 38401954 DOI: 10.1016/j.jebdp.2023.101951] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 02/26/2024]
Abstract
Dental patient-centered outcomes can improve the relevance of clinical study results to dental patients and generate evidence to optimize health outcomes for dental patients. Dental patient-reported outcomes (dPROs) are of great importance to patient-centered dental care. They can be used to evaluate the health outcomes of an individual patient about the impact of oral diseases and treatment, and to assess the quality of oral health care delivery for a health care entity. dPROs are measured with dental patient-reported outcome measures (dPROMs). dPROMs should be validated and tested before wider dissemination and application to ensure that they can accurately capture the intended dPROs. Evidence suggests inadequate dPRO usage among dental trials, as well as potential flaws in some existing dPROMs. This Glossary presents a collection of main terms in dental patient-centered outcomes to help clinicians and researchers read and understand patient-centered clinical studies in dentistry.
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Affiliation(s)
- Danchen Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
| | - Mike T John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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Patel J, Nattabi B, Long R, Durey A, Naoum S, Kruger E, Slack-Smith L. The 5C model: A proposed continuous quality improvement framework for volunteer dental services in remote Australian Aboriginal communities. Community Dent Oral Epidemiol 2023; 51:1150-1158. [PMID: 36812158 DOI: 10.1111/cdoe.12850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVES Aboriginal and Torres Strait Islander communities in remote parts of Australia are some of the most underserviced communities in regard to oral health care. These communities rely on volunteer dental programmes such as the Kimberley Dental Team to fill the gaps in care, however, there are no known continuous quality improvement (CQI) frameworks to guide such organizations to ensure that they are delivering high-quality, community-centred, culturally appropriate care. This study proposes a CQI framework model for voluntary dental programmes providing care to remote Aboriginal communities. METHODS Relevant CQI models wherein the (i) behaviour of interest was quality improvement, and (ii) the health context was volunteer services in Aboriginal communities were identified from the literature. The conceptual models were subsequently augmented using a 'best fit' framework and the existing evidence synthesized to develop a CQI framework that aims to guide volunteer dental services to develop local priorities and enhance current dental practice. RESULTS A cyclical five-phase model is proposed starting with consultation and moving through the phases of data collection, consideration, collaboration and celebration. CONCLUSIONS This is the first proposed CQI framework for volunteer dental services working with Aboriginal communities. The framework enables volunteers to ensure that the quality of care provided is commensurate with the community needs and informed by community consultation. It is anticipated that future mixed methods research will enable formal evaluation of the 5C model and CQI strategies focusing on oral health among Aboriginal communities.
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Affiliation(s)
- Jilen Patel
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Barbara Nattabi
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Robyn Long
- Jungarni-Jutiya Indigenous Corporation, Halls Creek, Western Australia, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Steven Naoum
- Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Estie Kruger
- School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Hynninen Y, Voltti S, Sormunen M, Nihtilä A, Siukosaari P, Koukkula L, Leskelä RL. Oral Health Outcome Measures: A Feasibility Evaluation. Int Dent J 2023; 73:685-691. [PMID: 36697290 PMCID: PMC10509398 DOI: 10.1016/j.identj.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/12/2022] [Accepted: 12/24/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Outcomes of oral health care must be measured and analysed to improve oral health care delivery, outcomes, and quality. This study aims to develop and test outcome measures for the needs of oral health organisers and explore their feasibility using clinical data. METHODS Based on the literature review and oral health advisory board, outcome measures for oral health care were identified, developed, and tested. Data from 425,000 clinical examinations were obtained from the clinical records of 8 public oral care providers in Finland. RESULTS The advisory board selected 7 outcome measures: 1 on oral self-care, 2 on periodontitis, 3 on caries, and 1 on missing teeth. A large variation was found in the diagnostic and data entry practices of these outcome measures. The coverage of caries and missing teeth entries was good, but the quality of initial and remineralised caries entries was questionable. The caries and missing teeth measures show statistically significant differences amongst some providers. CONCLUSIONS The measures "new cavitated caries surfaces," "cavity-free clinical examinations," and "the change in the missing value" were evaluated as feasible. The results of these measures provided insight about the effectiveness of oral care and enabled the comparison between the providers and age groups. Statistically significant differences between the providers in the measures imply potential possibilities for providers to learn from each other.
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Affiliation(s)
| | | | | | - Annamari Nihtilä
- Insitute of Dentistry, University of Eastern Finland, Kuopio, Finland; Social and Health Services, City of Espoo, Finland
| | - Päivi Siukosaari
- University of Helsinki, Faculty of Medicine, Department of Oral and Maxillofacial Diseases, Helsinki, Finland; Helsinki University Hospital, Helsinki, Finland
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Khamnil Y, Kao-Iean S, Pisarnturakit PP. Scale development to measure the patient perception of patient-centered care of dentists in primary care settings of Thailand: a measurement invariance test. BMC Oral Health 2023; 23:626. [PMID: 37660040 PMCID: PMC10474778 DOI: 10.1186/s12903-023-03331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND Patient-centered care is essential for providing quality services thoroughly at the primary care level, but it is unclear and lacks measurement. This study aimed to develop a reliable and valid instrument to measure patient perception of patient-centered care in primary dental care in Thailand and test the measurement invariance between large and small community hospitals. METHODS The initial set of 45 items for the patient perception of Patient-Centered Care of Dentist Scale (PCCDS-P version) was developed using a mixed-method approach, which included a literature review, a content validity test, cognitive interviews, and a pre-test. A multistage sampling strategy was used to recruit dental patients or their parents or caregivers from community hospitals across Thailand. Validity was examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha coefficient and the intraclass correlation coefficient. Furthermore, a multi-group analysis was conducted to compare the responses of patients from large and small community hospitals. RESULTS Three hundred thirty-six and One thousand one hundred sixty-seven samples were randomized for EFA and CFA, respectively. The final PCCDS-P version consists of 7 factors with satisfactory reliability and validity and is composed of 42 items: dentist-patient relationship, disease-illness, integrated care, communication, shared information and decision-making, holistic, and empathy and anxiety management. The CFA showed the model fit was consistent with the entire sample. The metric invariance analysis showed that the factor loadings were invariant across patient groups. Overall, Cronbach's alpha coefficient and intraclass correlation coefficient were satisfactory. CONCLUSIONS The newly developed PCCDS-P version is composed of seven domains with 42 items with good reliability and validity, and it indicated measurement invariance across patients in large and small community hospitals.
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Affiliation(s)
- Yutthana Khamnil
- Graduate Program in Dental Public Health, Faculty of Dentistry, Chulalongkorn University, Patumwan, Bangkok, 10330, Thailand
| | - Surasak Kao-Iean
- Research Unit of CYD and Department of Educational Research and Psychology, Faculty of Education, Chulalongkorn University, Patumwan, Bangkok, 10330, Thailand
| | - Pagaporn Pantuwadee Pisarnturakit
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, 34 Henry Dunant Road, Patumwan, Bangkok, 10330, Thailand.
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Dyer TA, Mulligan S, Martin N. Sustainability as part of a quality framework for the organisation of oral healthcare. Br Dent J 2023; 235:309-312. [PMID: 37684456 DOI: 10.1038/s41415-023-6269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 09/10/2023]
Abstract
This paper aims to highlight to the reader that the organisation of dentistry at a system level lags behind other healthcare professions in regulation, policy, education and research. It argues that seeing sustainability as being as important as safety in oral healthcare quality would begin to rectify this. For the practitioner, it also identifies existing guidance on practising sustainably and reinforces that it does not require radical change but evidence-based care.
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Affiliation(s)
- Thomas A Dyer
- Senior Clinical Teacher in Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
| | - Steven Mulligan
- General Dental Practitioner and Clinical Teacher in Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Nicolas Martin
- Professor of Restorative Dentistry and Honorary Consultant in Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
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Thompson W, Teoh L, Pulcini C, Sanderson S, Williams D, Carter V, Pitkeathley C, Walsh T. International Consensus on a Dental Antibiotic Stewardship Core Outcome Set. Int Dent J 2023; 73:456-462. [PMID: 37055238 DOI: 10.1016/j.identj.2023.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION Antibiotic resistance is a global health crisis. Ensuring responsible, appropriate use (stewardship) is an important for keeping antibiotics working as long as possible. Around 10% of antibiotics across health care are prescribed by oral health care professionals, with high rates of unnecessary use. To maximise the value from research to optimise antibiotic use in dentistry, this study developed international consensus on a core outcome set for dental antibiotic stewardship. METHODS Candidate outcomes were sourced from a literature review. International participants were recruited via professional bodies, patient organisations, and social media, with at least 30 dentists, academics, and patient contributors in total. Outcomes scored "critical for inclusion" by >70% of the participants (dentists, academics, and patients) after 2 Delphi rounds were included in the core outcome set following a final consensus meeting. The study protocol was registered with the COMET Initiative and published in BMC Trials. RESULTS A total of 33 participants from 15 countries, including 8 low- and middle-income countries, completed both rounds of the Delphi study. Antibiotic use outcomes (eg, appropriateness of prescribing), adverse or poor outcomes (eg, complications from disease progression), and a patient-reported outcome were included in the final, agreed core set. Outcomes relating to quality, time, and cost were not included. CONCLUSIONS This core outcome set for dental antibiotic stewardship represents the minimum which future studies of antibiotic stewardship in dentistry should report. By supporting researchers to design and report their studies in a way meaningful to multiple stakeholders and enabling international comparisons, the oral health profession's contribution to global efforts to tackle antibiotic resistance can be further improved.
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Affiliation(s)
| | - Leanne Teoh
- University of Melbourne, Melbourne, Australia
| | | | | | | | | | | | - Tanya Walsh
- University of Manchester, Manchester, United Kingdom
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Wang Q, Tu X, Fu Y, Zhang J, Wei X, Zhu Z, Wang T, Yang L. Variation in quality of care by medical institute level in China: a systematic review protocol. BMJ Open 2023; 13:e067683. [PMID: 36717137 PMCID: PMC9887710 DOI: 10.1136/bmjopen-2022-067683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Quality variation has been widely witnessed and discussed in China. However, limited evidence reveals quality gaps by the medical institute level, especially between hospitals and primary care institutes. This systematic review will synthesise the available evidence on quality variation between medical institutes at different levels in China. By adopting a quality framework, we will also explore the detailed domains (structure, process and outcomes) and dimensions (safety, effectiveness, timeliness, patient-centredness, efficiency, integration and equity) of quality gaps. METHODS AND ANALYSIS An extensive literature search will be conducted on eight key electronic databases: MEDLINE, Web of Science, Cochrane Library, Scopus, EMBASE, ProQuest, China National Knowledge Infrastructure and WANFANG database. The Grey Matter Checklist will be used to screen relevant grey literature. The publication time limit should be before 31 December 2022 when we plan to conduct a literature search. All kinds of studies that revealed the quality difference between medical institutes at different levels will be included, no matter if quality improvement intervention is involved. All quality measures and indicators will be recorded and sorted into appropriate domains and dimensions. For those studies that took the completion rate of standard operations to assess the quality, we will also record the name of the clinical pathways, guidelines or checklists used. Two reviewers will independently perform the study selection, data extraction and quality assessment process. A narrative or quantitative synthesis will be performed based on the available data. ETHICS AND DISSEMINATION Ethics approval is not applicable. The results of this study will be submitted to a widely accepted peer-review journal. The findings will also be used to inform administration about quality gaps by different medical institute levels and, therefore, help them to design policies that will minimise the quality variation. PROSPERO REGISTRATION NUMBER CRD42022345933.
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Affiliation(s)
- Quan Wang
- School of Public Health, Peking University Health Science Center, Beijing, China
- Brown School, Washington University in St Louis, St Louis, Missouri, USA
| | - Xi Tu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yaqun Fu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jiawei Zhang
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xia Wei
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Zheng Zhu
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ting Wang
- School of Public Health, Shandong University, Jinan, Shandong, China
| | - Li Yang
- School of Public Health, Peking University Health Science Center, Beijing, China
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Patel J, Durey A, Naoum S, Kruger E, Slack-Smith L. A scoping review to inform the use of continuous quality improvement in Australian Aboriginal oral health care. AUST HEALTH REV 2022; 46:478-484. [PMID: 35831033 DOI: 10.1071/ah21394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
ObjectiveThe need to improve existing services to Aboriginal communities is prioritised by Australia's National Oral Health Plan. Although only an emerging area in dentistry, continuous quality improvement (CQI) approaches have positively impacted the delivery of primary health services to Aboriginal communities. This scoping review maps the applicability of CQI strategies to Aboriginal Australian oral healthcare services.MethodsA scoping review was conducted and studies that reported using CQI approaches to improve existing oral health services or quality of care deemed relevant to Aboriginal Australian communities were included.ResultsA total of 73 articles were retrieved and eight articles were included in the final synthesis. Several CQI tools were identified, including: plan-do-study-act cycles, dental quality alliance measures, prioritisation matrices, causal mapping and the use of collective impact methodology.ConclusionData exploring CQI in the context of Aboriginal oral health is scarce. The plan-do-study-act cycle and its variations show potential applicability to Aboriginal oral health care. However, for CQI approaches to be adequately implemented, the prevailing model of dental care requires a paradigm shift from quality assurance to quality improvement, acknowledging the impact of structural and process elements on care.
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Affiliation(s)
- Jilen Patel
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia; and Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - Steven Naoum
- Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Estie Kruger
- School of Human Sciences, The University of Western Australia, WA, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
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Effectiveness of and Patient’s Satisfaction with Dental Emergency Unit in Pitié Salpêtrière Hospital (Paris), Focusing on Pain and Anxiety. Int J Dent 2022; 2022:8457608. [PMID: 35637654 PMCID: PMC9148244 DOI: 10.1155/2022/8457608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/02/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Dental Emergency Unit (DEU) of the Pitié Salpêtrière Hospital receives mainly painful emergencies. This study aimed at evaluating the suppression of pain and anxiety as well as the patient's satisfaction after a visit to the DEU. Patients and Methods. A prospective study was carried out in 2019 (NCT03819036) in adult patients. Data was collected on D0 on site and then on D1, D3, and D7 by phone, during daytime. The main objective and secondary objectives were, respectively, to assess the intensity of pain on D1; the intensity of pain on D3 and D7; the evolution of anxiety on D1, D3, and D7; and the patients' satisfaction. They were evaluated with a 0–10 numeric scale (NS) on D1, D3 and D7; mean scores were compared with nonparametric statistics (ANOVA, Dunn's test). Results 814 patients were contacted and 581 patients included; 87 were lost to follow-up. 376 patients completed all the questionnaires. In the final sample (59% men, 40 ± 16 y.o.), 86% had health insurance. The mean pain scores were as follows: D0: 6.36 ± 0.12; D1: 3.49 ± 0.13; D3: 2.23 ± 0.13; D7: 1.07 ± 0.11—indicating a significant decrease of 45%, 65%, and 93% on D1, D3, and D7, respectively, compared to D0 (p < 0.0001) between D0 and D1, D3, D7. The mean NS anxiety scores were as follows: D0: 3.32 ± 0.15; D1: 3.69 ± 0.16; D3: 2.75 ± 0.16; D7: 1.98 ± 0.15. The decrease was significant between D0 and D7 (p < 0.0001). The perception of general heath improved between D1 and D7. The overall score of satisfaction was 8.64 ± 0.06. Conclusion DEU enabled a significant reduction in pain and anxiety with high overall satisfaction.
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Benoit B, Frédéric B, Jean-Charles D. Current state of dental informatics in the field of health information systems: a scoping review. BMC Oral Health 2022; 22:131. [PMID: 35439988 PMCID: PMC9020044 DOI: 10.1186/s12903-022-02163-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Over the past 50 years, dental informatics has developed significantly in the field of health information systems. Accordingly, several studies have been conducted on standardized clinical coding systems, data capture, and clinical data reuse in dentistry. Methods Based on the definition of health information systems, the literature search was divided into three specific sub-searches: “standardized clinical coding systems,” “data capture,” and “reuse of routine patient care data.” PubMed and Web of Science were searched for peer-reviewed articles. The review was conducted following the PRISMA-ScR protocol. Results A total of 44 articles were identified for inclusion in the review. Of these, 15 were related to “standardized clinical coding systems,” 15 to “data capture,” and 14 to “reuse of routine patient care data.” Articles related to standardized clinical coding systems focused on the design and/or development of proposed systems, on their evaluation and validation, on their adoption in academic settings, and on user perception. Articles related to data capture addressed the issue of data completeness, evaluated user interfaces and workflow integration, and proposed technical solutions. Finally, articles related to reuse of routine patient care data focused on clinical decision support systems centered on patient care, institutional or population-based health monitoring support systems, and clinical research. Conclusions While the development of health information systems, and especially standardized clinical coding systems, has led to significant progress in research and quality measures, most reviewed articles were published in the US. Clinical decision support systems that reuse EDR data have been little studied. Likewise, few studies have examined the working environment of dental practitioners or the pedagogical value of using health information systems in dentistry. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02163-9.
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Affiliation(s)
- Ballester Benoit
- Pôle d'Odontologie, Assistance Publique des Hôpitaux de Marseille, Marseille, France. .,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
| | - Bukiet Frédéric
- Pôle d'Odontologie, Assistance Publique des Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Dufour Jean-Charles
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.,APHM, Hôpital de la Timone, Service Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
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Crisan EL, Covaliu BF, Chis DM. A Systematic Literature Review of Quality Management Initiatives in Dental Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11084. [PMID: 34769604 PMCID: PMC8582852 DOI: 10.3390/ijerph182111084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/16/2021] [Accepted: 10/17/2021] [Indexed: 12/17/2022]
Abstract
By considering the recently proposed definitions and metrics, oral healthcare quality management (OHQM) emerges as a distinct field in the wider healthcare area. The goal of this paper is to systematically review quality management initiatives (QMIs) implementation by dental clinics. The research methodology approach is a review of 72 sources that have been analyzed using the Context-Intervention-Mechanism-Outcome Framework (CIMO). The analysis identifies five mechanisms that explain how quality management initiatives are implemented by dental clinics. The simplest QMIs implementations are related to (1) overall quality. The next ones, in terms of complexity, are related to (2) patient satisfaction, (3) service quality, (4) internal processes improvement, and (5) business outcomes. This paper is the first attempt to provide a critical review of this topic and represents an important advancement by providing a theoretical framework that explains how quality management is implemented by practitioners in this field. The results can be used by scholars for advancing their studies related to this emerging research area and by healthcare managers in order to better implement their quality management initiatives.
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Affiliation(s)
- Emil Lucian Crisan
- Faculty of Economics and Business Administration, Department of Management, Babes-Bolyai University, 400591 Cluj-Napoca, Romania;
| | - Bogdan Florin Covaliu
- Faculty of Medicine, Department of Community Medicine, Public Health and Management, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 400337 Cluj-Napoca, Romania
| | - Diana Maria Chis
- Faculty of Economics and Business Administration, Department of Finance, Babes-Bolyai University, 400591 Cluj-Napoca, Romania;
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Baâdoudi F, Maskrey N, Listl S, van der Heijden G, Duijster D. Usage and Scientific Properties of the ADVOCATE Oral Health Care Measures. JDR Clin Trans Res 2020; 5:385-398. [PMID: 31991088 PMCID: PMC7495713 DOI: 10.1177/2380084420902464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Feedback information about the quality of oral health care is important for reflective learning by oral health care professionals and the wider health system. To this end, a list of 48 topics describing oral health and oral health care was recently agreed as part of the EU H2020 ADVOCATE project. OBJECTIVE This article reports on the formulation of measures based on the ADVOCATE topics and provides information on usage, reporting, validity, and reliability of the measures. METHODS The AIRE instrument was used to guide the methodological approach adopted. The appropriateness of the measures was tested among 39 general dental practitioners (GDPs) in Denmark, Germany, and the Netherlands. Data were collected from a convenience sample of patients via a questionnaire deployed in an online application in their practice. Feasibility, acceptability, and usefulness of the measures were evaluated through focus group interviews with GDPs. Face validity and test-retest reliability of the measures were assessed. RESULTS For 46 of the 48 topics, a measure could be defined by constructing a definition and a numerator and denominator. Data collection for all 46 measures was feasible and acceptable for patients using the online questionnaire. The practicalities of using claims data for the purpose of giving feedback to individual and groups of GDPs proved to be challenging in terms of timely access of such data, the granularity of the data, and matching the content of the data with the consented items on quality of oral health care. Face validity was considered appropriate, as the patients found the questionnaire easy to understand. Test-retest reliability was found to be acceptable for 36 of 46 measures. CONCLUSION The broad range of the ADVOCATE oral health care measures could make a useful contribution to a more transparent, evidence-based, and patient-centered oral health care system. KNOWLEDGE TRANSFER STATEMENT This study shows the usage, reliability, and validity of 46 oral health care measures. The measures, which include patient experience and health behaviors, were found to be useful to stimulate discussions about clinical practice. The measures can provide essential information for quality improvement strategies and useful and relevant feedback information for GDPs.
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Affiliation(s)
- F. Baâdoudi
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands
| | - N. Maskrey
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands
- School of Pharmacy, Keele University, Newcastle under Lyme, Staffordshire, UK
| | - S. Listl
- Department of Conservative Dentistry, Section for Translational Health Economics, Heidelberg University, Heidelberg, Germany
- Department of Dentistry–Quality and Safety of Oral Health Care, Radboud University–Radboudumc, Nijmegen, the Netherlands
| | - G.J.M.G. van der Heijden
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands
| | - D. Duijster
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands
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Hill H, Howarth E, Walsh T, Tickle M, Birch S, Brocklehurst P. The impact of changing provider remuneration on clinical activity and quality of care: Evaluation of a pilot NHS contract in Northern Ireland. Community Dent Oral Epidemiol 2020; 48:395-401. [DOI: 10.1111/cdoe.12544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/02/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Harry Hill
- School of Health and Related Research University of Sheffield Sheffield UK
| | | | - Tanya Walsh
- School of Dentistry University of Manchester Manchester UK
| | - Martin Tickle
- School of Dentistry University of Manchester Manchester UK
| | - Stephen Birch
- Health Services Research & Primary Care University of Manchester Manchester UK
- Centre for Business and Economics of Health University of Queensland Australia
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Berthelsen H, Owen M, Wretlind K, Westerlund H. Does staff-assessed care quality predict early failure of dental fillings? A prospective study. Community Dent Oral Epidemiol 2020; 48:387-394. [PMID: 32469125 DOI: 10.1111/cdoe.12543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 04/03/2020] [Accepted: 05/03/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate staff-assessed care quality as an indicator of register-based measures of care quality at dental clinics, more specifically register-based measures of survival of dental fillings and initiation of preventive treatments for caries patients. METHODS This prospective study includes data from cross-sectional workplace psychosocial risk assessment surveys at dental clinics and register data on survival of dental fillings, and initiation of preventive treatment for caries patients obtained from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa) Demographic background data on the age, gender, income level and place of birth of patients was obtained from Statistics Sweden (SCB). The data were analysed using discrete-time multilevel survival analysis and multiple linear regression analysis. RESULTS The results showed that staff-assessed care quality rated by the total staff or by dental nurses at the clinic predicted the risk of replacement of dental fillings made due to a caries diagnosis during the 3-year follow-up period, controlling for potential confounding due to patient demographic characteristics (age, sex, income and country of birth). In contrast, the better the staff-assessed care quality at the clinic, the smaller the proportion of the patients received preventive care in addition to operative caries therapy when controlling for potential confounding due to patient demographics. Care quality assessed by dentists at the clinic did not predict either of these outcome measures. CONCLUSIONS Premature failure of dental fillings is costly for both patients and society, which leads to a need for relevant measures for following dental care quality. Our findings indicate that staff-assessed care quality - a cheap and easy measure to collect and follow continuously in dental practice - can be used to monitor aspects of quality in real time in order to facilitate continuous improvement and quickly amend quality problems. Also, it can be used for integrating quality improvement in systematic work environment risk management.
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Affiliation(s)
- Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, Malmö, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, SA, Australia
| | | | - Hugo Westerlund
- The Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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Byrne M, O’Malley L, Glenny AM, Campbell S, Tickle M. A RAND/UCLA appropriateness method study to identify the dimensions of quality in primary dental care and quality measurement indicators. Br Dent J 2020; 228:83-88. [DOI: 10.1038/s41415-020-1200-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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17
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Abstract
This paper sets out a conceptual framework by which quality improvement in primary dental care can be approached. We argue that seeking a unified definition for quality in dentistry is a distraction to the more important end of quality improvement. An approach to quality improvement that interfaces Donabedian's domains of structure, process and outcome with various dimensions of quality gives a rational approach by which quality can be assessed and improved. The importance of valid, evidence driven indicators and methods for their implementation in primary dental care is described. Further work is required in order to identify which dimensions of dentistry are most important, but the Institute of Medicine's dimensions of safety, effectiveness, patient centreedness, timeliness, equity, efficiency are a good starting point. Trying to develop an absolute list of dimensions of quality should not distract from implementing an approach-based paradigm of quality improvement. Bioinformatics offers new solutions by which quality measures may be implemented and reported in the primary care setting. The focus of future research should be in implementing data-driven quality indicators at the level of the primary care practitioner.
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Ramalho A, Castro P, Gonçalves-Pinho M, Teixeira J, Santos JV, Viana J, Lobo M, Santos P, Freitas A. Primary health care quality indicators: An umbrella review. PLoS One 2019; 14:e0220888. [PMID: 31419235 PMCID: PMC6697344 DOI: 10.1371/journal.pone.0220888] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/22/2019] [Indexed: 01/08/2023] Open
Abstract
Nowadays, evaluating the quality of health services, especially in primary health care (PHC), is increasingly important. In a historical perspective, the Department of Health (United Kingdom) developed and proposed a range of indicators in 1998, and lately several health, social and political organizations have defined and implemented different sets of PHC quality indicators. Some systematic reviews in PHC quality indicators are reported but only in specific contexts and conditions. The aim of this study is to characterize and provide a list of indicators discussed in the literature to support managers and clinicians in decision-making processes, through an umbrella review on PHC quality indicators. The methodology was performed according to PRISMA Statement. Indicators from 33 eligible systematic reviews were categorized according to the dimensions of care, function, type of care, domains and condition contexts. Of a total of 727 indicators or groups of indicators, 74.5% (n = 542) were classified in process category and 89.5% (n = 537) with chronic type of care (n = 428; 58.8%) and effective domain (n = 423; 58.1%) with the most frequent values in categorizations by dimensions. The results of this overview of reviews are valuable and imply the need for future research and practice regarding primary health care quality indicators in the most varied conditions and contexts to generate new discussions about their use, comparison and implementation.
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Affiliation(s)
- André Ramalho
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
| | - Pedro Castro
- USF Camélias, ACeS Grande Porto VII (ARS Norte)–Vila Nova de Gaia, Portugal
| | - Manuel Gonçalves-Pinho
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
| | - Juliana Teixeira
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Vasco Santos
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACeS Grande Porto VIII (ARS Norte)–Espinho/Gaia, Portugal
| | - João Viana
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
| | - Mariana Lobo
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
| | - Paulo Santos
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
| | - Alberto Freitas
- MEDCIDS–Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS–Centre for Health Technology and Services Research, Porto, Portugal
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