Fonda G. Robinson, DMD, is Associate Dean, Clinic Administration and Patient Care, and Associate Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry; Henry Fischbach, DDS, is Assistant Dean, Predoctoral Clinic Operations, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry; Jessica Salisbury, BSDH, MS, is in private practice and Chief Operations Officer, Grove City, OH; Dawne Stefanik, DDS, is Assistant Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry; Rachel Kearney, BSDH, MS, is Division Chair and Associate Professor, Division of Dental Hygiene, The Ohio State University College of Dentistry; and Henry W. Fields, DDS, MS, MSD, is Division Chair and Professor, Division of Orthodontics, The Ohio State University College of Dentistry.
J Dent Educ. 2019 Sep;83(9):1030-1038. doi: 10.21815/JDE.019.105. Epub 2019 May 13.
Dental care in the U.S. is based on a general practice model of care delivery that can be enhanced by the integration of the dentists and allied dental professionals. There are 25 U.S. dental schools with associated dental hygiene programs, presenting distinctive opportunities for educating the dental health care team. Integrated educational clinical experiences are believed to positively influence teamwork and quality of care that parallels the authentic general practice environment. Lean management, developed by Toyota and used in a variety of types of organizations including health care, provides a distinctive blend of engineering principles and operations management to enhance business and operations processes. A fundamental principle of Lean management is the elimination of waste and preservation of only those value-added components of a process. The faculty and staff of The Ohio State University College of Dentistry, trained in Lean process improvement, applied techniques to enhance and integrate an inefficient patient intake (admissions) process. The aim of this initiative was to improve patient throughput in the patient intake process and to provide dental and dental hygiene students with enhanced educational experiences from improved clinical integration. These goals were achieved through streamlining patient flow and relocating major phases of the process. Although new patient retention and cancellation/no-show rates remained mostly unchanged, this enhancement project resulted in improved access to care, improved continuity of care, expanded scope of dental services offered, improved patient satisfaction, and enhanced dental and dental hygiene student collaboration and teamwork. These outcomes suggest that process improvement initiatives can serve as valuable opportunities for integration of the dental health care team.
美国的牙科护理基于一种普遍的实践护理模式，可以通过整合牙医和牙科相关专业人员来增强。美国有 25 所设有牙科卫生学项目的牙科学校，为牙科保健团队的教育提供了独特的机会。整合教育临床经验被认为可以积极影响团队合作和护理质量，与真实的普通实践环境相媲美。精益管理由丰田公司开发，并在包括医疗保健在内的各种类型的组织中使用，它提供了独特的工程原理和运营管理的融合，以增强业务和运营流程。精益管理的一个基本原则是消除浪费，只保留流程中增值的部分。俄亥俄州立大学牙科学院的教职员工接受了精益流程改进的培训，他们应用这些技术来增强和整合效率低下的患者入院（就诊）流程。这一举措的目的是提高患者在就诊流程中的吞吐量，并为牙科和牙科卫生学生提供从改进的临床整合中获得的增强教育体验。这些目标是通过简化患者流程和重新定位流程的主要阶段来实现的。虽然新患者的保留率和取消/失约率基本保持不变，但这一增强项目改善了获得护理的机会，提高了护理的连续性，扩大了提供的牙科服务范围，提高了患者满意度，并增强了牙科和牙科卫生学生的协作和团队合作。这些结果表明，流程改进计划可以为整合牙科保健团队提供有价值的机会。
