Children's oral health in the medical curriculum: a collaborative intervention at a university-affiliated hospital.
The purpose of this study was to 1) describe the structure of the oral health program in a university-affiliated hospital; 2) evaluate staff's knowledge and attitudes toward oral health; and 3) propose ways to strengthen the incorporation of oral health prevention for children into clinical medical education. Qualitative methods were used to evaluate the program. Structured interviews with seventeen medical center personnel were conducted, and clinic utilization reports provided ICD-9 diagnostic frequency and visits. Clinic staff, pediatric residents, dental and pediatric faculty, hospital administrators, and clinic directors were interviewed. The themes identified during these interviews were motivation, roles, operational and organizational issues, and integration into the larger medical care system. Integration of an early childhood caries prevention program into the clinical medical education curriculum can be accomplished. After implementation of the oral health program described in this paper, dental caries became the eleventh most common diagnosis seen in the clinic when previously it did not appear in the top forty. However, institutional and organizational barriers are significant. Barriers identified were 1) lack of clarity in defining leadership and roles regarding oral health, 2) time and work overload in a busy pediatric clinic, 3) a tracking system was not available to quickly determine which children needed caries prevention procedures and education, and 4) billing and medical record form changes could not be fully established prior to starting the program.
Graham
Elinor
E
Department of Pediatrics, University of Washington, Box 359774, 325 Ninth Ave., Seattle, WA 98104, USA. ellieg@u.washington.edu
Negron
Reinaldo
R
Domoto
Peter
P
Milgrom
Peter
P
D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003479:Curriculum; D019033:Delivery of Health Care, Integrated; D003731:Dental Caries / Q000517:prevention & control; D004501:Education, Medical; D005568:Forms and Records Control; D006267:Health Education, Dental; D006740:Hospital Administrators; D006757:Hospital Units / Q000458:organization & administration; D006785:Hospitals, University / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000458:organization & administration; D007857:Leadership; D008499:Medical Records; D009042:Motivation; D009909:Oral Health; D010350:Patient Credit and Collection; D010377:Pediatric Dentistry / Q000193:education*; D010372:Pediatrics / Q000193:education / Q000458:organization & administration; D010564:Personnel, Hospital; D008486:Physician Executives; D016730:Program Development; D015397:Program Evaluation; D013997:Time Factors; D014861:Washington; D016526:Workload