Course Goals

The goals of this EQIPP course for the learner include:

• Implement current AAP guidelines and policies for the provision of oral healthcare in the pediatric medical home.
• Understand and teach others about the importance of the dental home, caries risk assessment, oral health anticipatory guidance, and fluoride varnish application. All of these should be addressed during office visits with pediatric primary healthcare providers (PPHPs)
• Create plans for improvement to address gaps identified in key clinical activities of oral healthcare. You will collect baseline and follow-up data as you work to improve care and processes through Plan, Do, Study, and Act (PDSA) cycles.
• Recognize barriers that complicate the provision of high-quality oral healthcare and identify processes/resources to overcome these barriers.

Objectives

By the end of this course, you will be able to:

• Discuss the importance of establishing the dental home with patients and families.
• Refer families to a dental home, while recognizing and helping them overcome barriers to the establishment of the dental home.
• Perform an oral health risk assessment at all recommended health supervision visits and as needed; among other risks, assess patients’:
  • Eating/drinking habits that place them at increased risk for dental caries
  • Daily oral healthcare routine (ie, clean infant gums after feeding, brushing/flossing)
  • Access to systemic fluoride
  • Sources of topical fluoride
• Use a formal assessment tool to assess risks for patients ≤6 years.
• Recognize the value of applying fluoride varnish in the pediatric medical home.
• Examine patients’ teeth and gums properly at each routine visit.
• Provide oral health anticipatory guidance suitable for the age, health literacy, language, and culture of the patient/family.
• Communicate steps to handle oral injuries if they occur and inform families about preventing injuries to the mouth and teeth.
• Realize the pediatric medical home’s ongoing responsibility to document/update/maintain the provision of oral health risk assessment, anticipatory guidance, and preventive care and have procedures in place to coordinate these efforts with all members of the care team.

Quality Improvement

Measure and improve care delivery and processes concerning oral healthcare by doing the following:

1. Collect and analyze baseline data.
2. Identify 1 or more performance gaps in key clinical activities of care.
3. Clarify the improvement idea to be tested for closing identified gap(s):
   • AIM: What are we trying to improve or accomplish?
   • MEASURES: How will we know that a change made is an improvement?
   • CHANGES: What changes can we make that will result in improvement?
4. Test ideas quickly on a small scale to determine if changes lead to improvement.
5. Collect and analyze 2 follow-up cycles to measure the results of the test.
6. Determine how to sustain successful changes to systematically integrate them into the practice’s culture, processes, and workflow.