Alkarimi Heba A, Jawadi Amal, Tayeb Shaimaa, Ismail Ramysh, AlShareef Esraa J, Sherbini Nouf
Dental Public Health, King Fahd Armed Forces Hospital (KFAFH), Jeddah, Saudi Arabia
Pediatric Dentistry, King Fahd Armed Forces Hospital (KFAFH), Jeddah, Saudi Arabia.
BMJ Open Qual. 2025 May 8;14(2):e003070. doi: 10.1136/bmjoq-2024-003070.
Dental caries is one of the most important health concerns in Saudi Arabia. It poses a substantial burden considering the clinical outcomes and treatment costs. Oral health is an integral part of general health, and primary healthcare providers may contribute to the primary prevention of caries by initiating early referrals, dental screening and early diagnosis of caries with regular medical visits.
This project aimed to integrate the Child Oral Health Initiative (COHI) into regular paediatric healthcare services to effectively promote oral health and improve access to preventive dental care services. However, referrals to the dental department were primarily paper-based targeting dental clearance, emergencies and treatments. This referral system impaired the accessibility and manageability of medical records, necessitating the need for a traceable robust referral system to successfully screen children.
The first phase of the project was to develop an electronic referral system for the COHI (ECOHI-referrals) to improve communication between the COHI dental team and other hospital teams, increase dental preventive screening rates and to track referrals. Four Plan-Do-Study-Act (PDSA) cycles were used to initiate and track the new referral system and improve the screening rate of referred children.
After implementation, the number of ECOHI-referrals for caries prevention in the paediatric ward increased from 0 to 351 during the project period. The dental team received 351 ECOHI-referrals out of 420 (83.5%) eligible children in the paediatric ward. Of the referred 351 children, 317 (90.3%) underwent dental screening. Of the screened children, 263 (82.9%) established an ongoing dental home, and 98 (30.9%) children received fluoride applications.
Quality improvement methods facilitated the successful integration of COHI into hospital inpatient settings, increasing dental prevention visits to the paediatric ward, improving tracking of e-referrals, establishing dental homes for children and enhancing communication between teams.
龋齿是沙特阿拉伯最重要的健康问题之一。考虑到临床结果和治疗成本，它带来了沉重负担。口腔健康是整体健康的一个组成部分，基层医疗服务提供者可通过早期转诊、口腔筛查以及在定期就诊时对龋齿进行早期诊断，为龋齿的一级预防做出贡献。
本项目旨在将儿童口腔健康倡议（COHI）纳入常规儿科医疗服务，以有效促进口腔健康并改善预防性牙科护理服务的可及性。然而，转介到牙科部门主要是基于纸质文件，目标是牙科检查、急诊和治疗。这种转诊系统损害了病历的可及性和可管理性，因此需要一个可追踪的强大转诊系统来成功筛查儿童。
该项目的第一阶段是为COHI开发一个电子转诊系统（ECOHI-转诊），以改善COHI牙科团队与医院其他团队之间的沟通，提高牙科预防筛查率并追踪转诊情况。使用了四个计划-实施-研究-改进（PDSA）循环来启动和追踪新的转诊系统，并提高转诊儿童的筛查率。
实施后，项目期间儿科病房预防龋齿的ECOHI-转诊数量从0增加到351。牙科团队收到了儿科病房420名符合条件儿童中的351份ECOHI-转诊（83.5%）。在转诊的351名儿童中，317名（90.3%）接受了牙科筛查。在接受筛查的儿童中，263名（82.9%）建立了持续的牙科之家，98名（30.9%）儿童接受了氟化物应用。
质量改进方法有助于将COHI成功整合到医院住院环境中，增加了儿科病房的牙科预防就诊次数，改善了电子转诊的追踪，为儿童建立了牙科之家，并加强了团队之间的沟通。
