Quality improvement in practice – is it just more work?
Cindy Hannon, MSW, gets real on QI in dentistry
When it comes to health care, is more really better? Doing more and not knowing the answer can many times be just that - more - specifically, more work. This is where the science of improvement comes in – a method for measuring whether or not what we do is actually better.
Applying quality improvement (QI) to dentistry has been part of my work at the DentaQuest Institute (DQI) since 2011. So, when my colleague Dr. Brian Nový and I were asked to be part of an author team looking at using QI in dentistry for the Journal of the California Dental Association, we jumped at the chance. Thank you Journal of the California Dental Association for the opportunity to let more people know: dentistry is ready for QI.
Picture to the right: Me and Brian in Alabama (on the left side)
Health outcomes take time to change; but for caries management I think we can all agree on two goals: less new cavitation for high risk patients and healthy patients remain healthy. What exactly do we need to find out if a few process measures lead to those goals? A numerator and a denominator, for starters.
In our journal article, we feature the story of one 6-year-old child because it is a prime example of demonstrating the impact of person-centered care: "he experienced the chance to explore alternatives when he was unsuccessful and everyone involved in his care was motivated to find a risk-reduction strategy that he could easily implement." If we keep using visit time to tell people what to do, but our patients are not getting healthier, at some point we have to look at the system and ask, why are we not getting the results we want? This clinical evidence says that point has arrived.
Our article walks through the efforts taken to become a pediatric dental practice that effectively manages caries disease. Photographic evidence, run charts, steps to measure, other resources – it is all there.
Please read through the 6-year-old’s story. Photographic evidence, run charts, steps to measure, other resources – it is all there. But know, there are many more kids whose stories are captured by run charts within dental practices embracing this new era of health care. This is just the beginning. NNOHA, UCLA School of Dentistry and Kaiser Permanente, to name a few, are using QI right along with us.