Meeting Dental’s “Triple Aim”
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.