1 Albuquerque Area – A Year in Review

Tuesday, June 4, 2013Albuquerque Area Dental Chiefs/Prevention Coordinators Meeting

2

How long is Dr. Ricks going to be here?

I don’t know.

The ultimate goal is to get at least a half-time ADO for the Albuquerque Area.

3 ADO Workplan

4

Workplan Objective #1 Promote quality of care through site

visits to and program reviews of Area Dental Programs, to include the Balanced Scorecard, the IHS Chart Review Tool, and other tools as needed. 

Goal:  Conduct program reviews at half of the Albuquerque Title I, Title V, and Service Unit dental programs in FY 2013.

5

Workplan Objective #2 Promote GPRA performance on the

dental indicators of improving access to dental care, dental sealants, and patients benefitting from topical fluoride.

Goal:  Increase GPRA performance in all  3 dental measures, have at least 3 programs recognized nationally for GPRA dental performance.

6

Workplan Objective #3 Provide recruitment assistance to

Area dental programs.

Goal:  Have no longstanding vacancies in Albuquerque Area programs.

7

Workplan Objective #4 Provide continuing education to

Area dental staff through CE calls, online opportunities, and through an annual Area Dental Meeting.

Goal:  Increase standardization of dental policies and implementation across the Albuquerque Area.

8 Where are we headed?

Continuing EducationYear Monthly CE Calls Annual Area Dental Meeting Totals

CE Hours Mean Attendance Total Hours

CE Hours Mean Attendance Total Hours Total ParticipantHours

2007 9 18 164 20 33 660 824

2008 10 19 192 20 15 300 492

2009 13 39 507 17.75 35 621 1128

2010 20 33 660 19.5 19 370.5 1031

2011 9 36 324 19.75 32 632 956

Total 61 29 1769 97 27 2584 4353

Program Reviews & GPRA: ResultsQuality Measure 2007 2008 2009 2010 2011 % Change

‘07 to ‘11Program Reviews- Composite Scores 81.0 81.0 66.7 81.8 90.0 11.1- Mean Infection Control Score 70.5 70.5 89.4 89.6 88.9 26.1- Mean Chart Review Score 63.8 78.2 79.5 83.6 84.4 20.6Government Performance & Results Act- Access to Care 33.5% 35.1% 39.9% 40.3% 42.1% 25.7- Programs meeting access goal 14 15 16 14 16- % programs meeting access goal 93% 94% 100% 88% 100% 7.5- Sealants 7052 9303 12210 15526 14059 99.4- Programs meeting sealant goal 3 8 10 10 12- % programs meeting sealant goal 20% 50% 63% 63% 75% 275.0- Fluoride Patients 5521 6841 8545 9546 10246 85.6- Programs meeting fluoride goal 8 10 10 11 15- % programs meeting fluoride goal 53% 63% 63% 69% 94% 77.4- Programs meeting 3/3 goals 3 8 9 10 12- % programs meeting all goals 20% 50% 56% 63% 75% 275.0

Results: Key Quality Measures

Quality Measure 2002-2006 2007-2011 % Change

Clinical Productivity

- Relative Value Units (RVUs) 168,703 272,918 + 61.8- Patient Visits 32,650 52,120 + 59.6Clinical Efficiency- RVUs per patient visit 3.6 3.9 + 8.3- RVUs per FTE staff 2,316 3,120 + 34.7- Broken appointment rate 18% 13% - 27.8- % of patients treatment planned 40% 48% + 20.0- % of patients completing tx 25% 74% + 196.0- RVUs per patient 10.9 9.2 - 15.6- % Level I-III servicesa 94% 96% + 2.1Government Performance & Results Act- Access to care 33.0% 42.1% + 27.6- Patients receiving fluoride 4,684 10,246 + 118.8- Number of dental sealants 6,748 14,059 + 108.3

12 What have we achieved?

13

Program Reviews

Dental Program Name

Date of Review

Reviewer(s)

Credentialing & Privilegi

ng

Patient Safety Overall

Hazard Communication

s

Infection

Control

Emergency

Preparedness

Other Consider

ations

Chart Documentation

Policies &

Procedures

Quality Assuran

ce & Improve

ment

Productivity &

Efficiency

Oral HP/DP

Employee

Development

Overall Score

Rank, by Area

Rank, Overall

Albuquerque

2/15/2013 TR, SM 75 91 100 90 89 90 73 36 20 71 50 100 65 4/24/2013 TR, SM 100 88 86 88 86 90 911 93 100 33 100 100 88 4/23/2013 TR,SM 50 79 43 83 80 80 50 69 16 89 14 40 51 3/1/2013 TR, SM 100 93 100 90 100 100 95 86 100 59 50 100 85 2/28/2013 TR, SM 100 92 86 92 89 100 81 64 20 41 55 80 67 2/14/2013 TR, SM 75 95 100 93 100 100 81 54 50 89 50 100 74 2/13/2013 TR, SM 50 78 71 87 13 82 81 0 0 28 43 60 43 2/12/2013 TR, SM 50 91 83 92 100 88 69 14 20 50 38 80 52 2/12/2013 TR, SM 67 94 67 97 100 88 80 0 40 60 38 100 60 10/17/2012 TR, SM 63 92 86 94 100 90 78 57 33 18 9 60 51 10/16/2012 TR, SM 63 91 71 95 100 91 79 60 20 67 30 80 65

Average, Albuquerque Area 63 90 83 93 86 90 77 32 26 55 37 83 62

Date of Review

Credentialing &

Privileging

Patient Safety Overall

Hazard Communi

cationsInfection Control

Emergency

Preparedness

Other Consider

ations

Chart Documen

tation

Policies &

Procedures

Quality Assuranc

e & Improve

ment

Productivity &

EfficiencyOral

HP/DP

Employee

Development

Overall Score

Albuquerque

2/15/2013 75 91 100 90 89 90 73 36 20 71 50 100 65

4/24/2013 100 88 86 88 86 90 911 93 100 33 100 100 88

4/23/2013 50 79 43 83 80 80 50 69 16 89 14 40 51

3/1/2013 100 93 100 90 100 100 95 86 100 59 50 100 85

2/28/2013 100 92 86 92 89 100 81 64 20 41 55 80 67

2/14/2013 75 95 100 93 100 100 81 54 50 89 50 100 74

2/13/2013 50 78 71 87 13 82 81 0 0 28 43 60 43

2/12/2013 50 91 83 92 100 88 69 14 20 50 38 80 52

2/12/2013 67 94 67 97 100 88 80 0 40 60 38 100 60

10/17/2012 63 92 86 94 100 90 78 57 33 18 9 60 51

10/16/2012 63 91 71 95 100 91 79 60 20 67 30 80 65

14

Comparison, ABQ vs. NAS

020406080

100Average, Nashville Area Average, Albuquerque Area

15

Continuing Dental Education so far

17

8

20

9

34

11

77

12

0

10

20

30

40

50

60

70

80

January March

ParticipantsPrograms

16

Continuing Dental Education Totals Total CE to be provided to

chiefs/prevention coordinators: 22.25 + 10 = 32.25

Total CE to be provided to other dental staff: 10

Remember that it is the licensed provider’s responsibility, not the IHS’, to achieve enough continuing education to maintain licensure

17

What about the national program? The existing IHS CDE contract expired at

the end of FY 2012.

The Nashville Area is providing temporary assistance by contracting with Dr. Mary Beth Kinney until September 30, 2013.

After that time, IHS Headquarters will assume responsibility for the CDE program.

18

The Future of IHS CDE Dr. Karol to IHS ADO Group on 5/7/13:

“Virtual continuing education will become the standard for most meetings.”

There will be fewer in-person IHS CDE courses in the future, but there will still be some (EFDA, specialty courses).

We need to continue to explore and exploit online/conference call CDE.

19 Other changes/improvements

20

Standardization Re-credentialing Reporting Template GPRA Report Cards PSR card Code books Caries risk classification

21

Ongoing Professional Practice Evaluation (OPPE)

22

New Reporting TemplateXYZ Service Unit Dental Program

Key Performance Indicators: ProductivityFiscal Year 2012

Month Total Patients Patient Visits Emergency/WI Patients Relative Value Units Total ServicesAnnual QI Goal (27% users) 5,971 No standard 31,453 21,700October 102 314 85 1211 606November 149 251 52 1671 667December 236 377 64 1320 5571st quarter FY 2012 487 942 201 4202 1830January 117 255 55 1537 571February 103 282 66 1842 564March 167 374 82 1809 6292nd quarter FY 2012 387 911 203 5181 1764April 100 296 70 1625 762May 102 360 59 1791 730June 94 346 77 1912 9823rd quarter FY 2012 296 1002 206 5328 2474July 94 447 69 1783 884August 118 455 98 2437 1,258September 105 381 59 2051 9264th quarter FY 2012 317 1283 226 6271 3068Fiscal Year 2012 Total 1487 4138 836 20982 9136

Fiscal Year 2013Month Total Patients Patient Visits Emergency/WI Patients Relative Value Units Total ServicesAnnual QI Goal (30% users) 5,971 No standard 31,453 21,700October 287 405 85 1749 795November 166 322 60 1578 653December 122 294 68 1478 7481st quarter FY 2013 575 1021 213 4805 2196January 124 342 73 1793 916February 76 323 65 1796 870March 2nd quarter FY 2013 April May June 3rd quarter FY 2013 July August September 4th quarter FY 2013 Fiscal Year 2013 Total

0300600 487 387 296 317

575

Total Patients Served, By Quarter

0600

1200 942 911 1002 1283 1021

Total Patient Visits, By Quarter

23

GPRA Report Card

PSR/CPITN Codes

From: Periodontal Screening and Recording: Early Detection of Periodontal Diseases, by Tanya Villalpando Mitchell, RDH, MS.

25

Other ADO Activities Caries Risk Classification Children’s Dental Health Month articles Area HP/DP mini-awards Oral Cancer Fact Sheet Dental Assistants Week Blood Pressure Guidelines Privileges Request Form

26 The Dental Support Center

27

DSC Work Plan Goals Utilize strategic program planning and

evaluation principles to ensure that perceived stakeholder needs are identified and met

Serve as a centralized source of support, technical assistant and resources for clinical and community-based oral health promotion and disease prevention initiatives across the Area

Collaborate with local, state, Area-wide and national partners to address the broad challenges and opportunities associated with preventive and clinical dental programs

28

Accomplishments – Quarter 1 Oral health education: development of

Diabetes and Oral Health Continuing education: delivered 7 CDE

hours (Pediatric Update with Dr. Jessica Lee; AIDC Study Club)

Program Review: Zuni by AIDC completed

Evaluation: developed DSC evaluation RFP

29

Accomplishments – Quarter 2 Perceived stakeholder needs: facilitate

positive, productive working relationships with new Area Dental Officer

Funding: 4 Area HPDP awards Program Review: Towaoc, Taos completed;

16 additional sites scheduled and confirmed Continuing Education: support

implementation of monthly CDE calls ECC Initiative: contract to develop 4 national

videos

30

Accomplishments – Quarter 3 Resources distributed: 2013 Coding Books, Area

Specialist List, Caries Risk Assessment Tool Collaboration: NAPPR Fluoride Varnish Initiative Program Review: Cochiti, San Felipe, Santo

Domingo, Zia, Isleta, Mescalero, AIDC completed Continuing Education: 18.5 CDE hours (CPA,

Program Planning, ITRs, AIDC Study Club, Collaborating with Head Start)

Children’s Dental Health Month

31

Accomplishments – Quarter 4 Resources distributed: Prevention Coordinator

Core Competencies First Birthday Card Initiative: 8 sites Program Review: Southern Ute, Jicarilla completed Continuing Education: establish 22.5 CDE hours

(Annual Meeting); support delivery of 3 hours (Infection Control, Quality Improvement, AIDC Study Club)

ECC Initiative: national distribution of Prescription for Oral Health including development of Spotlight Article

32

So what does DSC do in our spare time?

ANYTHING ELSE

YOU ASK US TO!

33

Such as . . . Screenings, health fairs and other community

based events Fulfilling your requests for patient education

materials Conducting patient, parent and/or staff

education at WIC, Head Start, Schools, Senior Centers

Representing Dental on Health Advisory Boards Or anything else that supports you and/or your

staff!