Department of Oral Surgery, Glasgow Dental Hospital and School, NHS Greater Glasgow and Clyde, Glasgow, UK
Glasgow Dental Hospital and School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
BMJ Open Qual. 2022 Mar;11(1). doi: 10.1136/bmjoq-2021-001700.
On 3 August 2020, Public Health Scotland commenced a prospective surveillance study to monitor the prevalence of COVID-19 among asymptomatic outpatients attending dental clinics across 14 health boards in Scotland.
The primary aim of this quality improvement project was to increase the number of COVID-19 tests carried out in one of the participating sites, Glasgow Dental Hospital and School. The secondary aim was to identify barriers to patient participation and staff engagement when implementing a public health initiative in an outpatient setting.
A quality improvement working group met weekly to discuss hospital findings, identify drivers and change ideas. Details on reasons for patient non-participation were recorded and questionnaires on project barriers were distributed to staff. In response to findings, rapid interventions were implemented to fast-track increases in the numbers of tests being carried out.
Over 16 weeks, 972 tests were carried out by Glasgow Dental Hospital and School Secondary Care Services. The number of tests per week increased from 19 (week 1) to 129 (week 16). This compares to a similar 'control' site, where the number of tests carried out remained unchanged; 38 (week 1) to 36 (week 16). The most frequent reason given for non-participation was fear that the swab would hurt. For staff, lack of time and forgetting to ask patients were identified as the most significant barriers.
Public health surveillance programmes can be integrated rapidly into outpatient settings. This project has shown that a quality improvement approach can be successful in integrating such programmes. The key interventions used were staff engagement initiatives and front-line data collection. Implementation barriers were also identified using staff questionnaires.
2020 年 8 月 3 日，苏格兰公共卫生局启动了一项前瞻性监测研究，以监测苏格兰 14 个卫生委员会的牙科诊所中无症状门诊患者的 COVID-19 患病率。
本质量改进项目的主要目的是增加参与的一个站点（格拉斯哥牙科医院和学校）进行的 COVID-19 检测数量。次要目的是确定在门诊环境中实施公共卫生倡议时患者参与和员工参与的障碍。
质量改进工作组每周开会讨论医院的发现，确定驱动因素和变革思路。记录患者不参与的原因，并向员工分发关于项目障碍的问卷。针对调查结果，迅速采取干预措施，快速增加检测数量。
在 16 周内，格拉斯哥牙科医院和学校的二级保健服务进行了 972 次检测。每周检测次数从 19 次（第 1 周）增加到 129 次（第 16 周）。相比之下，类似的“对照”站点的检测数量保持不变，仍为 38 次（第 1 周）至 36 次（第 16 周）。不参与的最常见原因是担心拭子会受伤。对于员工来说，缺乏时间和忘记询问患者被认为是最大的障碍。
公共卫生监测计划可以迅速纳入门诊环境。该项目表明，质量改进方法可以成功地整合此类计划。使用的主要干预措施是员工参与计划和一线数据收集。还通过员工问卷确定了实施障碍。
