Your SlideShare is downloading. ×
Bernard Tolpin.ppt
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Bernard Tolpin.ppt

364
views

Published on


0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
364
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Service Learning Collaboration & The Integration of Lutheran Medical Center Postdoctoral Residency Training Programs in Community Health Centers Neal Demby, DMD, MPH Director, Dept of Dental Medicine Anna D’Emilio, DDS Director, AEGD Program Bernard Tolpin, DDS, MPH Associate Director, Dept of Dental Medicine Susan Dietrich, DDS Director, Graduate Dental Education
  • 2. Lutheran Medical Center
    • 476 + bed  teaching hospital
    • Level 1 Trauma Center
    • Only hospital-based CHC (Federally qualified health center) in the country
    • 600,000+ encounters at main site
    • 75,000+ dental encounters at main site
    • 120,000+ dental encounters at extramural partnership sites
    • Culturally Diverse Populations
  • 3.  
  • 4. Service Learning Mission
    • Recruitment & retention of oral health providers remains a critical and chronic problem in assuring access to care; centers face challenges with workforce and budgets.
    • Through the establishment of creative, collaborative partnerships between LMC dental education programs and community health centers, a major workforce initiative has been put in place to develop a cost effective means for centers to ameliorate access issues for the most vulnerable .
    • Health centers have the resources to provide the learning/educational environment to new dentists.
  • 5. Collaboration Advantages
    • LMC pays resident salary & benefits
    • LMC provides financial reimbursement to sites for administrative time
    • Site retains all income generated by the resident
    • LMC consultant faculty appointment
    • CE opportunities; faculty development
    • ADA accreditation of clinical training site
    • Recruitment and retention of providers
    • “ Win-win situation”
  • 6. Collaborative Partnerships
    • Community Health Centers (FQHCs)
    • Public Health Departments
    • Indian Health Services
    • Group practices (profit & non-profit)
    • Health Science Centers
    • Managed Care Organizations
    • Veterans Administration
    • Community Hospitals
    • Health Departments
    • AHEC
    • Prison Health Systems
  • 7. PRIMARY CARE DENTAL RESIDENCY (Initial Program Yr) ADA COMMISSION ON DENTAL ACCREDIATION (Latest approval) LENGTH OF PROGRAM NUMBER OF RESIDENTS ENROLLED 2008-2009 GENERAL PRACTICE RESIDENCY (GPR) 1974 APPROVAL 2002 1 YEAR OPTIONAL 2 ND YEAR 11 ADVANCED EDUCATION IN GENERAL DENTISTRY (AEGD) 1988 APPROVAL 2006 1 YEAR OPTIONAL 2 ND YEAR 73 ADVANCED EDUCATION IN PEDIATRIC DENTISTRY 1994 APPROVAL 2002 2 YEARS 26 ADVANCED EDUCATION IN ENDODONTICS 2004 APPROVAL 2007 2 YEARS 6 DENTAL ANESTHESIOLOGY 2008 INITIAL ACCREDITATION 2008 2 YEARS 8
  • 8. LMC Program & Partnership Evolution
    • AEGD Program
    • 1988
    • 1 resident; 1 site
    • 2008
    • 73 residents; 61 sites
    • PEDS Program
    • 1994
    • 2 residents; 1 site
    • 2008
    • 26 residents; 3 sites
  • 9. Current States: Alaska, Arizona, California, Colorado, Hawaii, Massachusetts, Maryland, Michigan, Mississippi, New Mexico, New York, Rhode Island, Tennessee Future: New Jersey, Oregon, Connecticut, New Hampshire Lutheran Medical Center Dental Residency Network
  • 10. ALASKA Yukon-Kuskokwin Health Bethel, Alaska
  • 11. ARIZONA Mountain Park Health Center 635 East Baseline Road Phoenix, Arizona 85042 AEGD Residents El Rio Health Center Northwest 4009 N Flowing Wells Tucson, Arizona 86705 AEGD Residents North Country CHC Flagstaff, Arizona AEGD Residents Winslow Indian Health Center Winslow, Arizona AEGD Residents Sells Indian Health Service AEGD Residents Mariposa Community Health Center 1852 N Mastick Way Nogales, Arizona 85621 AEGD Residents Dental Net 1057 N Kolb Road Tucson Arizona 85710 AEGD Residents Sun Life Family HC 865 N Arizona Road Casa Grande, AZ 85222 AEGD Residents Dental Net 4747 N 7 th Street Phoenix, Arizona AEGD Residents Dental Net 5905 W Bell Road Glendale, Arizona 85308 AEGD Residents El Rio Health Center Southwest 1530 Commerce Street Tucson, Arizona 85746 AEGD Residents Pascua Yaqui Tribal Dental Center 7490 S. Camino De Oeste Tucson, Arizona 85746 AEGD Residents EL Rio Health Center Downtown 639 W Congress Street Tucson, Arizona 85745 AEGD Residents
  • 12. COLORADO Marillac Clinic Grand Junction, Colorado AEGD Residents Valley Wide Health Center 186 Hurt Street Center. Colorado AEGD Residents Valley Health Center 204 Carson Avenue Alamosa, Colorado 81101 AEGD Residents Valley Health Center 375 East Park Avenue Durango, Colorado 81301 AEGD Residents
  • 13. HAWAIIAN ISLANDS Keaau Family Health Center Dental Clinic 16-192 Pilimua Street Keaau, Hawaii 96749 AEGD Residents Maui Oral Health Initiative 310 W Kaahumanu Avenue Kahuliu, Hawaii 96732 AEGD Residents Kokua Kalihi Valley 2239 N School Street Honolulu, Hawaii 96819 AEGD Residents Kalhi-Palama HC 915 N King Street Honolulu, HI 96817 AEGD Residents Kaua’I Community Health Center 4643 Waimea Canyon Drive Waimea, Hawaii 96796 AEGD Residents Waianae Coast Comprehensive HC 86-260 Farrington Highway Waianae, Oahu, Hawaii 96792 AEGD Residents
  • 14. BOSTON MASSACHUSETTS South Cove Community HC 885 Washington Street Boston, MA 02111 AEGD Residents South Cove Quincy 275 Hancock Street Quincy, MA 02171 AEGD Residents Codman Square Health Cener Washington Street Dorchester, MA 02124 AEGD Residents Harvard Street Health Center Blue Hill Avenue Dorchester, MA 02124 AEGD Residents Dorchester House Health Center 1353 Dorchester Avenue Dorchester, MA 02122 AEGD Residents Dimock Community Health Center 55 Dimock Street Roxbury, MA 02119 AEGD Residents Whittier Street HC 1125 Tremont Street Roxbury, MA 02120 AEGD Residents Boston Public Oral Health 774 Albany Street Roxbury, MA 02118 AEGD Residents Joseph M Smith Family Health Center 287 Western Avenue Alston, MA 02134 AEGD Residents
  • 15. NEW MEXICO Indian Health Service Dental Clinic Albuquerque, NM AEGD Residents Acomo-Canoncito-Laguna Indian Health Service Grants, NM AEGD Residents Santa Fe Indian Health Service Hospital 1700 Cerrillos Road Santa Fe, NM 87505 AEGD Residents
  • 16. METROPOLITAN NY AREA Sunset Park Family Health Center 150 55 th Street Brooklyn NY 11220 AEGD Residents Morris Heights Health Center 85 W Burnside Avenue Bronx, NY 10453 AEGD Residents Callen Lorde Community Health Center 356 W 18 Street New York, NY 10011 AEGD Residents Bedford-Stuyvesant Family Health Center 1413 Fulton Street Brooklyn, NY 11216 AEGD Residents Joseph P Addabbo Family Health Center 67 Rockaway Beach Blve. Arverne, NY 11692 AEGD Residents Brooklyn Chinese Family Health Center 812 54 th Street Brooklyn, NY 11220 AEGD Residents Park Ridge Family Health Center 6317 4 th Avenue Brooklyn, NY 11220 AEGD Residents Peekskill/Hudson River Health Center 1037 Main Street Peekskill, NY 10566 AEGD Residents
  • 17. CAPITAL DISTRICT UPSTATE NY Schenectady FHS 602 Craig St. Schenectady, NY 12307 AEGD Residents 1 st Advantage Dental 1202 Troy, Schenectady Rd, Latham, NY 12110 AEGD Residents Whitney Young FHC Lark Dr. & Arbor Dr. Albany, NY 12210 AEGD Residents
  • 18. PROVIDENCE RHODE ISLAND St. Joseph Hospital 21 Peace Street Providence, RI Pediatric Residency Program
  • 19. TENNESSEE
  • 20. Implementing an LMC Program at a Clinical Training Site
    • Site complies with ADA standards & program curriculum, including but not limited to:
    • Identify dentists who will provide clinical supervision of residents
    • Provide practice resources (auxiliaries, supplies, room, etc.)
    • Provide the required clinical experiences*
    • Evaluate clinical competency**
    • Provide support for didactic curriculum (resident schedule, cases, internet access, work space, etc.)
    • Include resident in QA program (chart audits, meetings, etc.)
    • Sites can collaborate together to share resident(s) or provide additional rotations/experiences
  • 21. *Required Clinical Experiences
    • Comprehensive multidisciplinary dental care
    • Patient assessment and diagnosis
    • Obtaining informed consent
    • Promoting disease prevention
    • Control of pain & anxiety (behavior & pharmacological)
    • Restoration of teeth (including single crowns)
    • Replacement of teeth (fixed partial dentures, removable partial dentures and complete dentures
    • Periodontal therapy (including surgery)
    • Endodontic therapy (including molar endo)
    • Hard and soft tissue surgery
    • Management of medical and dental emergencies
    • Medical risk assessment
  • 22. **Online Evaluation/Outcomes Assessment Applications
  • 23. Didactic Curriculum
    • Provided by LMC
    • Applications of distance learning within post doctoral dental education
      • Synchronous Learning via Video teleconferencing
      • Asynchronous Learning via web-based applications
    • Regional Education
  • 24. Growth of distance learning via video teleconferencing
    • 1994
    • 20 residents, 2 didactic sites
    • (14 years later)
    • 2008
    • 118 residents, 24 didactic sites, 64 CHCs
  • 25. Requirements for Distance Learning
    • Identify a didactic site for the region or islands
    • Purchase equipment or utilize a local network site
    • LMC uses a bridging service – Expedite
    • Expedite
      • Performs test calls with new didactic site
      • Connects all sites for VTC sessions
    • Weekly confirmation of connection times
    • Facilitator – one or more dentists at each didactic site for weekly didactic sessions (assistant director + site faculty)
  • 26. Video Teleconferencing Sites Honolulu HI Tucson AZ Winslow AZ Ocala FL Albany NY Brooklyn NY Providence RI Boston MA Alamosa CO Maui HI Anchorage AK Memphis TN Keaau HI Bethel AK Juneau, AK Eastern Shore MD Holyoke MA Meridian MS Gallup NM Mesa AZ Jackson MI Oakland CA Redding CA San Juan PR
  • 27.  
  • 28. Columbia University School of Dental Medicine AT Still University/ ASDOH University of the Pacific Boston University University of Arizona Northern Arizona University University of Rochester/ Eastman Dental Center University of Missouri – Kansas City Hawaii Primary Care Association Penn State University – Hershey Idaho State University – Pocatello New York State OMRDD Marquette University Kaiser-Permanente Syracuse Medical Center Telecommunication Network
  • 29. Typical Week of a Resident Resident assignment to Saturday sessions are permitted with faculty supervision. Creative scheduling allowed providing there’s supervision and resident has minimum 40 hours devoted to the entire program. VTC based on EST; therefore allow for different starting times in other time zones – lecture may start in AM session MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY CLINIC ALL DAY AM CLINIC 1–5 PM – VTC/ DIDACTICS CLINIC ALL DAY CLINIC ALL DAY CLINIC ALL DAY
  • 30. Conclusion
    • These pivotal elements describe how vision, health policy, innovative ideas, can be translated to a major workforce program that increases access to services for the underserved, while maintaining an educational commitment to equity and service learning in postdoctoral education.
  • 31. Contacts
    • Susan Dietrich, DDS
    • Director, Graduate Dental Education
    • Phone: 646. 413. 8846
    • Email: [email_address]
    • Anna D’ Emilio, DDS
    • Director, AEGD Program
    • Phone: 718. 630. 7213
    • Email: [email_address]