Quality management in dental care: patients' perspectives on communication. a qualitative study

A Systematic Literature Review of Quality Management Initiatives in Dental Clinics

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.

Patient perceptions in quality of care: report from university veterans clinic

Background

The Heroes Clinic is a unique dental clinic housed at the University of Colorado School of Dental Medicine that offers military veterans dental care at no or minimal cost. The aim of this study is to collect patient feedback on their perception of the quality of care they receive at the Heroes clinic.

Methods

A cross-sectional study design was used to gather patient feedback on empathy and quality of care using Service Quality Measures (SERVQUAL) and Dental Satisfaction Questionnaire (DSQ) frameworks. Mean scores were calculated to determine the average of positive or negative responses. Fisher’s exact test was conducted to test any significant differences between the patients’ perception of quality of care they receive at the Heroes clinic (outcome variable) and the SERVQUAL and DSQ independent variables.

Results

One hundred and seventy-seven veterans responded to the survey with a response rate of 35%. Over 50% of patients were between the ages of 20–35 years and 63% were students. The mean scores demonstrated high levels of all variables. Bivariate analysis for SERVQUAL data determined that veterans agreed to conditions demonstrated by four scales of empathy and all scales of responsiveness (p < 0.05). DSQ bivariate analysis revealed that veterans agreed to conditions demonstrated by four scales of quality of care, two scales of pain management, one scale of accessibility, and also general satisfaction pertaining to the received dental care (p < 0.05).

Conclusions

Heroes clinic has provided quality dental care to veterans as attested by the patients.

Impact of Prominent Themes in Clinician-Patient Conversations on Caregiver's Perceived Quality of Communication with Paediatric Dental Visits

Patients’ perceived satisfaction is a key performance index of the quality health care service. Good communication has been found to increase patient’s perceived satisfaction. The purpose of this study was to examine the impact of the prominent themes arising from clinician-patient conversations on the caregiver’s perceived quality of communication during paediatric dental visits. 162 video recordings of clinical dental consultations for 62 cases attending the Paediatric Dentistry Clinic of The Prince Philip Dental Hospital in Hong Kong were captured and transcribed. The patients’ demographic information and the caregiver’s perceived quality of communication with the clinicians were recorded using the 16-item Dental Patient Feedback on Consultation skills questionnaires. Visual text analytics (Leximancer^™) indicated five prominent themes ‘disease / treatment’, ‘treatment procedure related instructions’, ‘preparation for examination’, ‘positive reinforcement / reassurance’, and ‘family / social history’ from the clinician-patient conversation of the recorded videos, with 60.2% of the total variance in concept words in this study explained through principal components analysis. Significant variation in perceived quality of communication was noted in five variables regarding the prominent theme ‘Positive reinforcement / reassurance’: ‘number of related words’ (p = 0.002), ‘number of related utterances’ (p = 0.001), ‘percentage of the related words in total number of words’ (p = 0.005), ‘percentage of the related utterances in total number of utterances’ (p = 0.035) and ‘percentage of time spent in total time duration’ (p = 0.023). Clinicians were perceived to be more patient-centered and empathetic if a larger proportion of their conversation showed positive reinforcement and reassurance via using related key words. Care-giver’s involvement, such as clinicians’ mention of the parent, was also seen as critical to perceptions of quality clinical experience. The study reveals the potential of the application of visual text analytics software in clinical consultations with implications for professional development regarding clinicians’ communication skills for improving patients’ clinical experiences and treatment satisfaction.