U N I V E R S I T Y O F M I C H I G A N S C H O O L O F D E N T I S T R Y 1 Quality Assessment and Assurance of Clinical Care Programs

U N I V E R S I T Y O F M I C H I G A N S C H O O L O F D E N T I S T R Y 2 AMERICAN DENTAL ASSOCIATION’S DEFINITIONS QUALITY ASSURANCE... the assessment of measurement of the quality of care and the implementation of any necessary changes to either maintain or improve the quality of care rendered. QUALITY ASSESSMENT: the measure of the quality and quantity of care provided in a particular setting.

U N I V E R S I T Y O F M I C H I G A N S C H O O L O F D E N T I S T R Y 3 MECHANISMS FOR QUALITY ASSURANCE IN DENTAL CARE STRUCTURE: –Accredited dental schools –Necessity for Licensure –Ethical codes –Professional traditions –In public health: services included and excluded PROCESS: –Licensure examinations –Mandatory continuing education –Peer review committees –Record audits –Practice inspections –In public health: dentists’ productivity and service mix OUTCOME: –Post-treatment examinations –Access or utilization measures

U N I V E R S I T Y O F M I C H I G A N S C H O O L O F D E N T I S T R Y 4 MECHANISMS OF QUALITY ASSURANCE On-site evaluations of dental practices –Structure, process, and outcomes –Record reviews –Management system Profiling of dental providers Computerized real-time evaluation Component of clinical quality assurance –Oral health status assessment –Appropriateness of care and decision making Completeness of diagnosis Integration of medical and social history in treatment plans Sequencing of treatment Risk management Preventive care and recall –Assessment of technical proficiency –Patients’ perceptions of treatment –Productivity (no quality without quantity (David Rosenstein))