Online Program

Not just drilling and filling: Adopting a disease management approach to manage early childhood caries

Monday, November 2, 2015

Adam Richman, DentaQuest Institute, Westborough, MA
Cindy Hannon, MSW, DentaQuest Institute, Westborough, MA
Richard Scoville, PhD, Scoville Associates, Chapel Hill, NC
Man Wai Ng, DDS, MPH, Department of Dentistry, Boston Children's Hospital, Boston, MA
Objectives: Early childhood caries (ECC) is one of the most prevalent chronic diseases in children and is largely influenced by social/behavioral factors. Studies have shown that a disease management (DM) approach is effective in managing ECC rather than relying solely on restorative treatment; however, implementing this requires significant system changes. To accelerate adoption of the DM approach, the DentaQuest Institute launched an initiative to create a national network of practices around using data to successfully adopt and spread DM protocols for ECC, including risk-assessment, self-management goal setting, and risk-based recall along with restorative treatments to reduce new cavitation, complaints of pain, and referrals to operating rooms.

Method: Over multiple building phases, 32 current practices collect monthly systems data as well as qualitative data and use this to track their progress, analyze gaps, and generate ideas to successfully implement the DM protocols into practice. Practices collaborate to exchange ideas and advice on adopting components of the DM protocols through regular meetings and project support designed to foster shared learning.

Results: In Phase 2, new cavitation, pain, and referrals decreased from baseline levels. Data collection for Phase 3 is ongoing and process measures have positive indications.

Conclusions: Based on experience, the initiative helped practices successfully adopt components of the DM protocols and create system changes that resulted in improved care delivery and patient outcomes. Preliminary Phase 3 results show positive changes in process measures indicating that the initiative has helped practices test important process changes that are beginning to improve health outcomes.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
List the components of the disease management protocol for early childhood caries. Describe how data were used to implement and adopt components of the disease management protocol to improve health outcomes.

Keyword(s): Oral Health, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Project Manager on this project since April 2013 and have been heavily involved in the implementation and execution of this initiative, specifically around the data collection process and tracking the progress of project participants. My interests are in chronic disease management and using quality improvement methodologies to improve health outcomes. I have been involved in several projects employing these strategies to improve population health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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