Quinonez Rocio B, Consky Elizabeth, Mattison Katrina, Randolph Greg
J Clin Pediatr Dent. 2017;41(5):351-357. doi: 10.17796/1053-4628-41.5.351.
To assess the use of quality improvement (QI) methods to implement an early childhood oral health program (Baby Oral Health Program-bOHP) in four federally qualified health center (FQHC) dental clinics.
Using a mixed-methods study design, survey responses, administrative data, QI project templates, and focus group measures were collected. Plan-Do-Study-Act (PDSA) cycles as mini-projects to improve the implementation of bOHP were examined. Data analysis included descriptive qualitative reviews and quantitative statistics at baseline, six, and 12 months following the intervention.
Twenty-three dental team providers in one urban and three rural clinics participated. Successful QI mini-projects included shortening time period between accepted referral and patient visits, improved documentation of caregiver interview, and efficiency of the infant oral health examination. Lack of change in provider confidence was observed, regardless of years of practice (p=0.93), years of employment (p=0.39), and dental team age (p=0.85). Qualitative reviews highlighted mixed QI results related to training and limited resources invested on follow-up of QI implementation.
A low cost, low resource pilot QI program as part of bOHP implementation showed mixed success, highlighting the critical role of training, staff committment, and leadership support to assure sustainable oral health programs in high-risk populations.
评估在四家联邦合格健康中心（FQHC）牙科诊所中使用质量改进（QI）方法实施幼儿口腔健康项目（婴儿口腔健康项目 - bOHP）的情况。
采用混合方法研究设计，收集了调查回复、行政数据、QI项目模板和焦点小组测量数据。对作为改进bOHP实施的微型项目的计划 - 实施 - 研究 - 改进（PDSA）循环进行了检查。数据分析包括在干预后的基线、6个月和12个月时进行描述性定性审查和定量统计。
一家城市诊所和三家农村诊所的23名牙科团队提供者参与其中。成功的QI微型项目包括缩短接受转诊与患者就诊之间的时间间隔、改善照顾者访谈记录以及婴儿口腔健康检查的效率。无论从业年限（p = 0.93）、工作年限（p = 0.39）和牙科团队年龄（p = 0.85）如何，提供者的信心均未发生变化。定性审查突出了与培训相关的混合QI结果以及在QI实施后续投入的资源有限。
作为bOHP实施一部分的低成本、低资源试点QI项目取得了喜忧参半的成功，突出了培训、员工投入和领导支持对于确保高危人群可持续口腔健康项目的关键作用。
