My issue/question is this: I see such a gap in equity to access to oral health care in our present health care delivery system. Also, as we continue to establish credible oral-system disease interactions, the void in inter-professional oral health knowledge and education has promulgated a lack of oral care for hospitalized patients in our country, a void not seen in the UK and other countries globally. It is now established that the lack of oral care for hospitalized patients negatively impacts health outcomes, can precipitate additional cardio-vascular events, and costs patients thousands of dollars in additional hospitalization days. Together with a small group of "Alternative Practice" dental hygienists in Washington State and with my experience in hospital dentistry, and based on current research of disease processes, I hope to contribute to improving health care outcomes for all, including hospitalized patients. In my future doctoral work, and through other efforts, I hope convince hospital CEOs, Boards, and the public of the need to staff hospitals and emergency departments with advance practice dental hygiene professionals and dental hygienists as they do any other "therapist" as is currently done elsewhere globally. Oral disease prevention through education and skills training for both other healthcare disciplines and patients is essential. Can you advise me how best to convince hospital CEOs and Boards to recognize the evidence and open their minds and doors to this change in our current care delivery system? My alternative practice colleagues and I had begun some grassroots work with individual hospital CEOs and I have begun to broach the subject with my local rural hospital CEO who was a great help during my thesis research on Non-Traumatic Dental Complaint patient Emergency Department utilization. Your work on focus groups and advocacy has inspired me to even come to you with this issue. I hope you can advise me how best I can be a more effect advocate to gather momentum for this greatly needed workforce change which would significantly improve health outcomes and prevent future suffering. Thank you, once again. I hope to hear from you soon.
Hi Jacqueline, and thanks for your question. You have raised a very important community health care need but probably face some big challenges on the way toward achieving your goals. I hear two goals: 1) to increase access to dental hygiene and care within hospital settings, and 2) to expand the utilization of your alternative practice colleagues within those settings. Therefore, you probably face at least two sets of potential challenges: 1) to persuade hospital systems, and 2) to persuade the Dental Society.
I could not tell from your question whether you are asking how to start locally or how to start statewide, and whether to start in King County or in Eastern Washington. It sounds like you already have a start in your home community, and your hospital administrator is one very good resource for advice as you think about how to proceed in that geograhoc area.
If I were in your shoes, I would go first (or next) to your local health department, because you are raising a public health issue. Partner with them in formally assessing community need for this access to dental hygiene and care. Work with them to raise the visibility of this need in their own formal community needs assessment, and also to ask that hospital systems raise the visibility of this issue in the community needs assessment reports required of hospitals. Ask if they are willing to invite the hospitals, dentists, advanced practice dental practitioners, and hygienists to participate in a health department-sponsored advisory committee to study the issues and develop strategy and implementation plans. If you can get the key parties talking together about this issue, your chances of eventual success improve.
A useful early focus might be to propose a pilot study offering these services to Medicaid-eligible persons, now that Washingon State Medicaid does provide some dental coverage. These are the people with the highest and most complicated physical and dental health care needs who have been underserved until now. If you want to start in King County, I suggest talking not only to King County Health Department but also to Harborview Medical Center early on. You might also want to talk to the Washington State Health Care Authority and to DSHS. They have an interest in preventive health initiatives. Wherever you start, make certain that the Washington Department of Health is aware of your efforts.
If all of that sounds like a big job, it is. However, it is also a very important undertaking well worth doing.
You are already familiar with CTB and its Learn a Skill chapters, so I won't spend time on them. I have flagged the relevant sections for your review
Best wishes! We hope this is helpful.