This project explored how demand for dental services can be met and sustained over time, with a focus on preventative care.
Aim
All adult clients on the wait list for the Moruya Public Dental Clinic will be assessed within recommended time frames, as per the Priority Oral Health Program (POHP) and Waiting List Management, with a focus on preventative dental care, by October 2018.1
Benefits
- Timely assessment and treatment of the adult population
- Shift to a preventative model of care in treatment provided
- Improved patient satisfaction
- Improved staff satisfaction and work place culture
- Potential for this project to be rolled out to other dental clinics within the local health disrtict (LHD) and beyond.
Background
Adult patients in the Moruya dental clinic experienced extensive wait times for assessment and treatment. In 2017, more than 300 patients waited well past recommended timeframes, as defined by the POHP, with most clients waiting more than two years for a dental assessment. A survey of the adult assessment waitlist showed that around 85% of patients were over 50 years old and around 70% of the patients were older than 60 years.
Historically, Moruya dental clinic has had a workforce shortage. Most treatment focussed on episodic care of acute problems, with little emphasis on prevention. This meant that clients who needed routine general treatment often waited much longer. With such lengthy wait times, and progression of dental disease, patients who could have been treated with relatively simple procedures, such as fillings and scale and clean, ended up having teeth extracted. This led to dissatisfaction amongst clients and staff.
By late 2017, the Moruya dental clinic was staffed with two full-time dental officers and a full-time oral health therapist and support staff. These consistent staffing levels enabled this project to begin in 2018 with the aim of reducing the waiting times for dental assessment and treatment and using available resources to create a preventative model of care.
Implementation
Following a review of current practices and available resources, both at Moruya and externally, a number of new processes were implemented.
- Roster templates were amended to include an additional 80-100 assessment appointments in the day book each month.
- An additional eight assessment days were added to appointment books.
- The use of external providers for general treatment through the Oral Health Fee for Service Scheme.2
- Dental officers from the local health district assisted with assessments, providing an additional four assessment days.
- Scale and clean appointments were referred to the oral health therapist (prevention clinic), leading to a 42% increase in the number of hygiene appointments over two months.
- Clients received oral health education materials with their assessment contact letters.
Status
Sustained – The project has been implemented and is sustained in standard business.
Key dates
- Start date: 1 March 2018
- End date: 31 October 2018
Implementation sites
Moruya dental clinic, Southern NSW LHD
Partnerships
Clinical Excellence Commission, Clinical Leadership Program
Results
The project led to a significant reduction in adult assessment wait times. By October 2018, all adult patients were assessed within recommended timeframes.
Prevention was embedded into clinical practice and clients are now offered preventative appointments and oral health education. Clients evaluated the changes favourably and staff reported improved workplace satisfaction.
Lessons learnt
- Quality improvement projects do work. We were able to change the previous model of care from an acute episodic approach, to placing prevention at the centre of everything we do.
- Preventative education can start at home, before an appointment with a health care provider.
References
- NSW Ministry of Health. Priority Oral Health Program (POHP) and Waiting List Management PD2017_023. North Sydney: NSW Health; 2017.
- NSW Ministry of Health. NSW Oral Health Fee for Service Scheme. North Sydney: NSW Health; 2017.
Contacts
Dr Aravinthan S Bharathy
Senior Dental Officer
Southern NSW LHD
Phone: 0423 724 545 | 02 4474 1531
Aravinthan.Somasuntharabharathy@health.nsw.gov.au
Lara Mayze
Oral Health Therapist
Phone: 02 4474 1531
Lara.Mayze@health.nsw.gov.au
