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A Pilot Quality Improvement Collaborative to Improve Safety Net Dental Access for Pregnant Women and Young Children

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Abstract

Objectives To determine acceptability and feasibility of a quality improvement (QI) collaborative in safety net dental practices, and evaluate its effects on financial stability, access, efficiency, and care for pregnant women and young children. Methods Five safety net dental practices participated in a 15-month learning collaborative utilizing business assessments, QI training, early childhood oral health training, and prenatal oral health training. Practices collected monthly data on: net revenue, no-show rates, total encounters, and number of encounters for young children and pregnant women. We analyzed quantitative data using paired t-tests before and after the collaborative and collected supplemental qualitative feedback from clinic staff through focus groups and directed email. Results All mean measures improved, including: higher monthly revenue ($28,380–$33,102, p = 0.37), decreased no-show rate (17.7–14.3%, p = 0.11), higher monthly dental health encounters (283–328, p = 0.08), and higher monthly encounters for young children (8.8–10.5, p = 0.65), and pregnant women (2.8–9.7, p = 0.29). Results varied by practice, with some demonstrating largest increases in encounters for young children and others pregnant women. Focus group participants reported that the collaborative improved access for pregnant women and young children, and that QI methods were often new and difficult. Conclusion for practice Participation by safety net dental practices in a QI collaborative is feasible and acceptable. Individual sites saw greater improvements in different outcomes areas, based on their own structures and needs. Future efforts should focus on specific needs of each dental practice and should offer additional QI training.

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Acknowledgements

Much thanks for safety net clinics participating in this collaborative: Catawba County Health Department, East Carolina University School of Dental Medicine, East Carolina University School of Dental Medicine Service Learning Center, Gaston Family Health Services, Macon County Health Department, Madison County Health Department, and Orange County Health Department. Additional thanks to Katrina Mattison, Lauria Davis, Marilyn Lewis, and Stephanie Forsyth for their assistance with this project.

Funding

This project was funded by a grant from the Blue Cross Blue Shield of North Carolina Foundation. EBV’s fellowship was funded by a Health Resources and Service Administration National Research Service Award Grant T32 HP14001.

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Correspondence to Emily B. Vander Schaaf.

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Vander Schaaf, E.B., Quinonez, R.B., Cornett, A.C. et al. A Pilot Quality Improvement Collaborative to Improve Safety Net Dental Access for Pregnant Women and Young Children. Matern Child Health J 22, 255–263 (2018). https://doi.org/10.1007/s10995-017-2397-6

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  • DOI: https://doi.org/10.1007/s10995-017-2397-6

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