Improvements in appropriate placement of dental sealants after implementation of a clinical decision support system.
Preventive care
caries
decision support systems
evidence-based dentistry
high caries risk
quality improvement
sealants
Journal
Journal of the American Dental Association (1939)
ISSN: 1943-4723
Titre abrégé: J Am Dent Assoc
Pays: England
ID NLM: 7503060
Informations de publication
Date de publication:
06 Apr 2024
06 Apr 2024
Historique:
received:
06
11
2023
revised:
12
01
2024
accepted:
15
02
2024
medline:
7
4
2024
pubmed:
7
4
2024
entrez:
7
4
2024
Statut:
aheadofprint
Résumé
Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS. A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to advise care team members whether a child was at elevated risk of developing caries and had sealant-eligible first or second molars. Data on dental sealant placement at examination visits during a 5-year period were analyzed, including 32 months before CDSS implementation and 28 months after CDSS implementation. From January 1, 2018, through December 31, 2022, the authors assessed 59,047 examination visits for children at elevated risk of developing caries and with sealant-eligible teeth. With the implementation of a CDSS and training to support the clinical care team members in September 2020, the appropriate placement of dental sealants at examination visits increased from 27% through 60% (P < .00001). Integration of a CDSS into the EHR as part of a quality improvement program was effective in increasing the delivery of sealants in eligible first and second molars of children aged 5 through 15 years and considered at high risk of developing caries. An EHR-based CDSS can be implemented to improve standardization and provide timely and appropriate patient care in dental practices.
Sections du résumé
BACKGROUND
BACKGROUND
Dental sealants are effective for the prevention of caries in children at elevated risk levels, and increasing the proportion of children and adolescents who have dental sealants on 1 or more molars is a Healthy People 2030 objective. Electronic health record (EHR)-based clinical decision support systems (CDSSs) have the ability to improve patient care. A dental quality measure related to dental sealant placement for children at elevated risk of caries was targeted for improvement using a CDSS.
METHODS
METHODS
A validated dental quality measure was adapted to assess a patient's need for dental sealant placement. A CDSS was implemented to advise care team members whether a child was at elevated risk of developing caries and had sealant-eligible first or second molars. Data on dental sealant placement at examination visits during a 5-year period were analyzed, including 32 months before CDSS implementation and 28 months after CDSS implementation.
RESULTS
RESULTS
From January 1, 2018, through December 31, 2022, the authors assessed 59,047 examination visits for children at elevated risk of developing caries and with sealant-eligible teeth. With the implementation of a CDSS and training to support the clinical care team members in September 2020, the appropriate placement of dental sealants at examination visits increased from 27% through 60% (P < .00001).
CONCLUSIONS
CONCLUSIONS
Integration of a CDSS into the EHR as part of a quality improvement program was effective in increasing the delivery of sealants in eligible first and second molars of children aged 5 through 15 years and considered at high risk of developing caries.
PRACTICAL IMPLICATIONS
CONCLUSIONS
An EHR-based CDSS can be implemented to improve standardization and provide timely and appropriate patient care in dental practices.
Identifiants
pubmed: 38583172
pii: S0002-8177(24)00110-7
doi: 10.1016/j.adaj.2024.02.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Dental Association. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure None of the authors reported any disclosures.