An audit of general dental practitioners' referral practice following the distribution of third molar guidelines.
Oral and maxillofacial surgery waiting lists are amongst the longest of any surgical specialty. The majority of patients on these waiting lists have been referred for removal of their third molars (wisdom teeth). With increasing pressure to reduce the size of both out-patient and surgical waiting lists, it is important to ensure that only those patients with a recognised clinical need are referred and accepted for treatment. In April 1998, local general dental practitioners were issued guidelines for the management of patients with impacted third molars. This paper describes an audit that assessed the impact of this intervention. The results suggest that referral guidelines are an effective means of changing general dental practitioners' referral practice and that, used along with other strategies, could be effective in reducing oral and maxillofacial surgery out-patient and surgical waiting lists. (+info)
An orthodontic patient administration system (OPAS) for complete departmental management.
There is a requirement for effective management and audit in today's hospital environment. This paper discusses some of the principal requirements of a computer program for comprehensive orthodontic department management and describes in detail one system. (+info)
Can audit improve antibiotic prescribing in general dental practice?
OBJECTIVE: To investigate whether clinical audit can improve general dental practitioners' prescribing of antibiotics. DESIGN: An intervention study carried out in general dental practice in the North West of England. METHOD: Information was collected over an initial six-week period from 175 general dental practitioners on their current antibiotic prescribing practices. The information collected was the antibiotic prescribed including dose, frequency and duration, the clinically presenting signs and conditions, the medical history (if for prophylaxis), and any other reasons for prescribing. This was compared to the practitioners' antibiotic prescribing for a further six-week period following an audit, which included an educational component and the issuing of guidelines. RESULTS: During the initial period practitioners issued 2316 prescriptions for antibiotics. This was reduced by 42.5% to 1330 during the audit. The majority of the antibiotics (81%) for both periods were prescribed for therapeutic reasons. The most commonly prescribed antibiotics were amoxycillin (57.6%), metronidazole (23.8%), penicillin (9.3%), erythromycin (4.8%) and a combination of amoxycillin and metronidazole (1.7%). The antibiotic regimens used by practitioners were significantly changed by the audit (P<0.001) and there was a significant reduction in the number of prescriptions (P<0.05) which did not conform to national guidelines. CONCLUSIONS: The results from this investigation support the conclusion that clinical audit, with the issuing of guidelines and an educational component, can change prescribing practices leading to a more rational and appropriate use of antibiotics in general dental practice. (+info)
Competency-based education in a clinical course in conservative dentistry.
The conceptual difference between a competency-based education and an education based upon a conventional dental curriculum is, perhaps, the starting point for the development of new curricula. The two systems are not, in themselves, exclusive. There is common ground to be found, and the concept of combining instruction with competency-based learning experiences is emerging in recent publications. This paper describes a competency-based approach applied to a clinical course in conservative dentistry. The learning outcomes of the fourth-year dental students in the new course were assessed using methods that included continuous clinical assessments, student presentations and peer-group reflective evaluations, patient management reviews, a clinical progress examination, the range and amount of work completed, and a written examination and viva voce. Different weightings were given to various elements of the assessment. A formal student assessment of the course rated it as being satisfactory. (+info)
General dental practitioners' experiences of a collaborative clinical audit on antibiotic prescribing: a qualitative study.
OBJECTIVE: To evaluate general dental practitioners' experiences of a multi-collaborative antibiotic prescribing audit. DESIGN: Qualitative analysis of compulsory post-audit group report data collection forms and individual practitioners' post-audit evaluation forms. SUBJECTS: Information was collected from 175 general dental practitioners in the North West of England who participated in the audit. METHOD: The general dental practitioners were divided into groups of 8-10 to undertake the audit. Information from compulsory post-audit group reports was transcribed and analysed. The information was categorised into a number of areas including changes in practice, patients' expectations, training and quality of service. On completion of the audit individual practitioners were asked to complete an evaluation form on the audit process. RESULTS: 141 (80.5%) individual evaluation forms were returned. Over 90% of GDPs felt that the audit process was easily understood and the majority of the practitioners thought the audit was worthwhile. Approximately 69% of participants felt that the audit had helped to change their antibiotic prescribing practices. Analysis of the post-audit group report data collection forms revealed more than 100 statements. The most common areas were changes required in practice, patients' expectations, increased training and quality of service. CONCLUSION: The collaborative clinical audit project was seen to be a worthwhile learning experience by the participating general dental practitioners. The audit encouraged GDPs to change their antibiotic prescribing practices and thereby improve patient care. GDPs also highlighted the need for continuing education in the prescribing of antibiotics. (+info)
A 10-year retrospective audit of consecutively completed orthodontic treatments in a general dental practice and a hospital orthodontic department.
During 1993 and 1994, the author took part in the South West Orthodontic Clinical Assistant Training Programme and worked as a part-time Clinical Assistant in the Orthodontic Department of the Royal United Hospital, Bath. Following the clinical assistantship the author continued to treat patients in the hospital department but under a General Dental Services contract number. This paper is a personal clinical audit of all the orthodontic cases completed within the GDS by the author since 1990, both in general practice in Westbury, Wiltshire and at the Royal United Hospital (RUH), Bath. The aim of the audit was to evaluate the effectiveness of orthodontic treatment carried out by the author, both in general dental practice and in a hospital orthodontic department, and to compare treatment outcomes with other published results. (+info)
Disability part 3: improving access to dental practices in Merseyside.
Several Merseyside dental practices took part in disability access audits of practice premises and practice staff took part in disability awareness training. Grants were awarded to part-fund improvements to practice facilities in line with the recommendations in the audit reports. The dental teams reported that the awareness training was very valuable and many common issues arose from the audits. Access for disabled people needs to be considered in all practice developments to ensure that dental practices comply with Part III of the Disability Discrimination Act by 2004. (+info)
Experience of 2 dental clinics registered to ISO 9002.
This paper describes the 3-year experience of managing 2 hospital-based dental clinics registered to ISO 9002:1994; it also examines the revision of previous quality management standards in 2 separate institutions to prepare for registration under the new ISO 9001:2000 standard. Daily equipment and process checks, combined with internal audits, were the backbone of the quality system at both locations. Corrective and protective actions had been underused, because of the partial duplication produced by 2 different institutionally mandated risk management and incident reporting systems. ISO 9002 registration provided both dental clinics with responsive quality systems, emphasizing patient satisfaction and providing measurable continuous quality improvement. (+info)