Oral Health Disparities Collaborative Update


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Oral Health Disparities Collaborative Update

  1. 1. Oral Health Disparities Collaborative Pilot Colleen Lampron, MPH Oral Health Pilot Co-chair Executive Director, National Network Oral Health Access
  2. 2. Overview <ul><li>Review of Oral Health Collaborative model </li></ul><ul><li>Discuss Oral Health Disparities Collaborative </li></ul><ul><li>Implementation Manual </li></ul><ul><li>Discuss how you can use this information </li></ul><ul><li>Review next steps </li></ul>
  3. 3. Acknowledgment <ul><li>Irene Hilton, DDS, MPH Oral Health Collaborative Pilot Co-Chair </li></ul><ul><li>Jay Anderson, DDS, MS – Faculty and Visionary </li></ul><ul><li>Marty Lieberman, DDS – Faculty </li></ul><ul><li>Francisco Ramos-Gomez, DDS, MPH – Faculty </li></ul><ul><li>Jim Sutherland, DDS, MPH </li></ul><ul><li>Pioneering Teams: </li></ul><ul><li>Community Health Partners, Livingston MT </li></ul><ul><li>High Plains Community Health Center, Lamar, CO </li></ul><ul><li>Salud Family Health Centers, Fort Lupton, CO </li></ul><ul><li>Sunrise Community Health Center, Greeley, CO </li></ul><ul><li>Tracy Jacobs, BSN IHI Collaborative Director </li></ul><ul><li>Kevin Little, PHD , Data Guru </li></ul>
  4. 4. Questions <ul><li>How many of you have participated in a Health Disparities Collaborative? </li></ul><ul><li>How many of your Health Centers have participated in a Collaborative? </li></ul><ul><li>How many of you were at the sessions on the Oral Health Collaborative last year? </li></ul>
  5. 5. A New Era of Best Practices <ul><li>Providing value-added preventive dental visits </li></ul><ul><li>Providing ECC risk assessment and disease management to very young children in the medical and dental settings </li></ul><ul><li>Providing comprehensive dental services to perinatal patients </li></ul><ul><li>Redesigning dental service delivery </li></ul>
  6. 6. Collaborative Aims <ul><li>Develop comprehensive primary oral health care system change interventions that generate major improvements in process and outcome measures for: </li></ul><ul><ul><li>Early childhood caries prevention and treatment </li></ul></ul><ul><ul><li>Perinatal oral health </li></ul></ul><ul><ul><li>Concurrent emphasis on practice redesign and office efficiencies that support improvements in the targeted areas </li></ul></ul>
  7. 9. Successes <ul><li>Improved access to oral health care for young children and pregnant women </li></ul><ul><li>Paradigm shift to approach clinical dentistry from a prevention standpoint </li></ul><ul><li>Developed oral health measures in PECS 3 </li></ul><ul><li>Medical and dental working together to improve patient outcomes </li></ul>
  8. 10. Results <ul><li>Focusing on the preventive approach rather than surgical or end-stage treatment </li></ul><ul><li>Integration of oral health in PECS 3 </li></ul><ul><li>Implementation and standardized referral mechanisms from medical to dental. </li></ul><ul><li>Greater collaboration and communication between medical and dental </li></ul><ul><li>Increased oral health knowledge of medical staff </li></ul>
  9. 11. Team Results <ul><li>Scheduling 8 days out vs. 4 months out </li></ul><ul><li>5% “no-show” vs. 12% “no-show” </li></ul><ul><li>40% Medicaid vs. 20% Medicaid </li></ul><ul><li>18.3pts/day vs.12pts/day (based on 8 hour day) </li></ul><ul><li>Dentist billed $51,281 Aug 2006 vs. $16,205 Aug 2005 </li></ul><ul><li>The OHDPC made dentistry relevant to the delivery of health care within a Community Health Center. The dental department is at the table and no longer a sideshow. </li></ul><ul><li>At Sunrise, we are a completely different department than we were 18 months ago and it shows in how we now practice dentistry. </li></ul>
  10. 12. The Business Case: Dental Medicaid Visits Salud Case Study
  11. 13. Pioneering National Leadership <ul><li>1 st organized oral health initiative in the county that has a protocol for treating pregnant women </li></ul><ul><li>1 st national entity that has a protocol for treating kids at age 1 </li></ul><ul><li>1 st national oral health quality improvement effort for Health Center dental programs </li></ul><ul><li>We have the technology, change package, and desire to do this </li></ul><ul><li>How do we get there? </li></ul>
  12. 14. Oral Health Disparities Collaborative Implementation Manual <ul><li>A tool to give Health Centers the opportunity to replace episodic, reactive care with comprehensive and proactive care, the Oral Health Disparities Collaborative offers the same for health center dental practices </li></ul>
  13. 15. Examples of Resources in the Library <ul><li>More than 30 resources </li></ul><ul><li>CAMBRA Risk Assessment – Caries Management by Risk Assessment – Caries risk assessment tool for children 0-5 years of age. </li></ul><ul><li>Example of Flow Child - An example of a process map of the flow of a young child visit. Author: Kevin Little, Ph.D., Martin Lieberman, DDS </li></ul>
  14. 16. Resources in the Library – Team Materials <ul><li>OHDP Patient Satisfaction Survey – Satisfaction survey for dental patients Author: Developed by the Oral Health Disparities Pilot </li></ul><ul><li>CHP Dental Balanced Scorecard – A dashboard of measures to assess program improvement and vitality. Author: Community Health Partners </li></ul><ul><li>High Plains CHC: Pedo Caries Risk Assessment – Sticker used for children ages 0-5 during initial exam and prevention visit. We print this onto a full page sticker then cut out so it will fit onto our progress note page. There are 2 entries per page. </li></ul><ul><li>Self Management Goal Setting forms </li></ul>
  15. 17. Resources – Research Articles <ul><li>Research Articles on pregnancy, early childhood oral health, and infant oral care </li></ul><ul><li>Oral Health and Pregnancy: A Review Author: Sangeeta Gajendra, B.D.S., M.P.H.;Jayanth V. Kumar, D.D.S., M.P.H. </li></ul><ul><li>Clinical Considerations for an Infant Oral Care Program Author: Francisco J. Ramos-Gomez, DDS, MS, MPH, Associate Professor of Pediatric Dentistry, University of California, San Francisco, San Francisco, California </li></ul><ul><li>ECC AG-6 step visit – Six steps for the child dental exam including Anticipatory Guidance </li></ul>
  16. 18. Resources – Power Point <ul><li>Perinatal Oral Health – A powerpoint presentation about oral health in pregnant women. Author: Jay R. Anderson, DMD, MHSA, </li></ul><ul><li>Redesign Tools Exercises –Power Point describing how to measure demand and capacity, work analysis, process mapping, waste analysis </li></ul><ul><li>Improving Access and Efficiency Dental – A presentation describing the principles behind improving access and practice efficiency in the dental setting. Author: Christine St. Andre, CSI LLC </li></ul>
  17. 19. Resources - Tools <ul><li>Cycle Time Tool - a tool used to measure the time of a patient visit (from when the patient enters the clinic to departure from clinic). Author: © 2001, Trustees of Dartmouth College, Godfrey, Nelson, Batalden, Institute for Healthcare Improvement </li></ul><ul><li>Oral Health DSD Indicators – A set of 6 Delivery System Design (also called redesign) measures to assess practice efficiency and patient care effectiveness. Author: Christine St. Andre, Colleen Lampron </li></ul>
  18. 20. The Manual <ul><li>A step-by-step guide to implementing your own oral health collaborative </li></ul><ul><li>Includes professionally developed and tested measures </li></ul><ul><li>Examples of high leverage changes </li></ul><ul><li>Explanation of what full integration looks like </li></ul><ul><li>The tools you need to get there. </li></ul>
  19. 21. Be Aware of Challenges <ul><li>Extensive training needed for dental staff </li></ul><ul><li>Competing organizational priorities may limit commitment </li></ul><ul><li>MIS/IT/data challenges </li></ul><ul><li>Capacity issues in dental </li></ul><ul><li>Prioritization of certain populations an issue </li></ul><ul><li>Doing this alone may be hazardous to your mental health </li></ul>
  20. 22. Do Try This at Home <ul><li>Talk to your Medical and Executive Directors about their experience of the oral health collaborative </li></ul><ul><li>Host a grand round/brown bag learning forum/learning opportunity for medical team about transmissibility, importance of early prevention </li></ul><ul><li>Build partnerships with medical for referrals and clinical protocols </li></ul>
  21. 23. Next Steps <ul><li>NNOHA will host conference calls on Thursday, March 13, 2008 at 1:00 Eastern (noon Central, 11:00 mtn, 10:00 pacific) </li></ul><ul><li>Manual will be posted on www.nnoha.org </li></ul><ul><li>Email notification will take place via listserve and postcard </li></ul>
  22. 24. The need <ul><li>Oral medicine is changing rapidly </li></ul><ul><li>Growing recognition of oral systemic connection </li></ul><ul><li>Widening gap between oral health of rich and poor </li></ul><ul><li>Prevention strategies exist that benefit the most vulnerable populations – the oral health collaborative implements these </li></ul>
  23. 25. Thank you <ul><li>More information: </li></ul><ul><li>Colleen Lampron: 720-838-7739 [email_address] </li></ul><ul><li>Irene Hilton: 415-657-1708 [email_address] </li></ul><ul><li>Jay Anderson: 301-594-4295 [email_address] </li></ul>