Innovating Quality Evaluation in Swedish Dental Care: Development and Testing of a New Assessment Method

Abstract

Objectives: Swedish dentistry is covered by a strict set of regulations via laws, constitutions and regulations. There is a need for further improvements in the area. We decided to start a framework for quality development based on the treatment patients have received. The objectives of this pilot study were to a) develop a questionnaire for evaluation of the documentation and dental care in Swedish dentistry, b) use this questionnaire to evaluate the documentation and dental care by dentists in our organization (Dentalum AB), and c) develop, validate and evaluate a short questionnaire version. Methods: An external expert in odontology and dental care developed a 98-item questionnaire about documentation/record keeping and patient care according to science and proven experience (named T98). 136 patient records from 22 of our clinics and 65 dentists were analyzed. The expert also proposed a short version questionnaire with 18 essential questions around patient safety (T18). Degree of fulfilled and unfulfilled efforts/measures was calculated for individual issues, subject areas and overall areas. Results: The average patient reached ca 70 and ca 30 % degrees of fulfilled and non-fulfilled efforts/measures, respectively. Low levels of fulfilment were found for some efforts/measures (6-31 %) and dentists (7 % with <50 %). This shows moderate overall and low individual compliance rates, underserved areas and development potential and needs. In 7 % of the cases, 90-100 % fulfilment was reached, which shows that top quality is reachable. Findings demonstrate that T18 can be used for more rapid and convenient evaluations without losing important information. Conclusion:  In this single-organization pilot study with assessments performed by one expert reviewer, we reached the primary objectives. T18 was found to be useful for faster and more convenient evaluations without losing essential information. We have created a basis for discussion about dental education, competence and competence assurance. Ultimately this is considered to strengthen skills and benefit patients.