title: Introducing care pathway commissioning to primary dental care: measuring performance.
abstract: Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.
authors.affiliation: Department of Health Services Research, Institute of Psychology, Health and Society, Room 113, Block B, Waterhouse Building, Liverpool University School of Dentistry, Liverpool, L69 3GL, UK. harrisrv@liverpool.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: Harris
authors.forename: C
authors.initials: C
authors.lastname: Bridgman
authors.forename: M
authors.initials: M
authors.lastname: Ahmad
authors.forename: L
authors.initials: L
authors.lastname: Bowes
authors.forename: R
authors.initials: R
authors.lastname: Haley
authors.forename: S
authors.initials: S
authors.lastname: Saleem
authors.forename: R
authors.initials: R
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Taylor
mesh_terms: D019091:Critical Pathways; D003729:Dental Care / Q000592:standards*; D005792:General Practice, Dental / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011313:Preventive Dentistry / Q000592:standards; D011320:Primary Health Care / Q000592:standards; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D018570:Risk Assessment; D013218:State Dentistry / Q000592:standards*; D006113:United Kingdom