Kailin E. Baechle
Kari Hexem
Tatyana Straus
| Kailin E. Baechle | Kari Hexem | Tatyana Straus |
Kailin E. Baechle1
Kari Hexem1,2, Tatyana Straus1,2, Joan Gluch1
1Division of Community Oral Health, Preventive & Restorative Sciences, University of Pennsylvania School of Dental Medicine; 2Philadelphia FIGHT, PDM
Description
Background: The process to complete removable prostheses requires many visits, significant time, and adequate commitment from patients. This process is especially difficult for patients who experience a more unpredictable lifestyle and increased barriers to receiving dental care. Philadelphia FIGHT is a FQHC that serves a community that is medically and socially complex, including patients with HIV, addiction, mental health conditions, the formerly incarcerated, or those experiencing homelessness. Issues involving patient compliance with treatment lead to longer treatment time required to receive prostheses and at times abandonment of treatment at various stages of the removable prosthesis. Intervention: The objective of this QI project was to assess barriers to care, improve the complete removable prosthesis experience for both patients and providers at Philadelphia FIGHT, and decrease the time required to complete removable treatment by implementing a consistent appointment time throughout the denture fabrication process involving a COH Honors student in patient care.
Project Overview
Problem Statement: Doctors at Philadelphia FIGHT have experienced increased treatment time required to finish complete removable prosthesis cases due to issues involving patient compliance with the treatment process.
Outcome
Results: In patients treated with a consistent appointment time, the average treatment time was decreased (15.2 weeks vs. 22.1 weeks). The average number of missed appointments during removable treatment was also decreased (0.43 vs. 1.10). The percent of cases completed without missing an appointment was doubled in this group (71% vs. 30%). Of the abandoned cases, 31% missed one appointment and never rescheduled, while another 31% missed multiple consecutive appointments before abandoning treatment. Conclusions: Implementing a more regular schedule for care resulted in fewer missed appointments and decreased removable treatment time for FIGHT patients during this quality improvement cycle. Results of this study can be used to improve the quality of complete removable prosthesis care and improve treatment outcomes in the Philadelphia FIGHT patient population.