best practices for state & local oral health programs
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Best Practices for State & Local Oral Health Programs. ASTDD Best Practices Project March 2010. Introduction to Best Practices. Optimal oral health across the lifespan…. Need for Best Practices. Oral Health in America: A Report of the Surgeon General. National Call To Action - PowerPoint PPT PresentationTRANSCRIPT
Best Practices forState & Local Oral Health Programs
ASTDD Best Practices Project
March 2010
Introduction to Best Practices
Optimal oral health across the lifespan…
Need for Best Practices
Oral Health in America:
A Report of the Surgeon General
Building Infrastructureand Capacity in
State and TerritorialOral Health Programs
Prepared by: ASTDD
National Call To Action To Promote Oral Health
A Public-Private Partnership
Under the leadership of The Office of
the Surgeon General
Need for Best Practices
To improve oral health andgeneral health status
To improve systems of care
Developing Best Practices
What will beyour program’s purpose
for developing best practices?
Association of State & TerritorialState Dental Directors (ASTDD)
Best Practices Project
ASTDD Best Practices ProjectPurpose
Build more effective state, territorial and community oral health programs.
For: Expand Infrastructure & Capacity Respond to National Call to Action Advance Healthy People 2010
ASTDD Best Practices ProjectGoal
Promote the development
of best practices by state,
territorial and community
oral health programs to
enhance the oral health of
Americans and reduce
disparities.
Uses ofBest Practice Information
Use as building blocks
Share ideas & lessons learned
Raise awareness of oral health
Promote collaborations
Update guidelines
End-Users ofBest Practice Information
BestPractices
Dental Directors
Public Health Programs
Coalitions
ConsumersFunders
Professional & Advocacy
Organizations
Government Officials & Staff
Best Practices forState & Local Oral Health Programs
Using Best Practice Concepts
Optimal oral health across the lifespan…
Best Practice Concepts
1. A best practice is a methodology that, through experience and research, has proven to reliably lead to a desired result.
2. Using best practices is a commitment to using all the knowledge and technology at one's disposal to ensure success.
Best Practice Concepts
3. Best practices do not have one template or form for everyone to follow.
4. “Best practice” does not commit people or organizations to one inflexible, unchanging practice.
Best Practice Concepts
5. Best practices is a philosophicalapproach based around continuouslearning & continual improvement.
6. Learning & transfer of best practicesis an interactive, ongoing & dynamicprocess that cannot rest on a staticbody of knowledge.
Best Practices forState & Local Oral Health Programs
Best Practice Criteria
Optimal oral health across the lifespan…
“Best Practice”
“Best” from whose perspective
and using what criteria?
Obtain Input from End-Usersfor Best Practice Criteria
Build consensus through selection & ranking of BP criteria
- Early buy-in
Collect additional information to guide selection of BP criteria
- Types of BP information end-users need
- Public health strategies in use
- Self-reported successful practices
Association of State & TerritorialState Dental Directors (ASTDD)
Best Practices Project
Setting Best Practice Criteria
ASTDD Best Practices ProjectInput from States
State surveys: Developed list of BP criteria
Ranked BP criteria
Identified categories of Best Practices information states wanted
Obtained listing of states’ reported top strategies and successful practices
ASTDD Best Practices ProjectBest Practice Criteria
Impact / Effectiveness
Efficiency / Cost Effectiveness
Demonstrated Sustainability
Collaboration / Integration
Objectives / Rationale
ASTDD Best Practices ProjectBest Practice Criteria
Impact / Effectiveness Provided benefits to the oral health care and well-being of certain populations or communities
Efficiency / Cost Effectiveness Showed costs and expenses are appropriate to benefits achieved
Demonstrated Sustainability Demonstrated sustainable benefits and/or demonstrated that the practice been sustainable within populations/communities and/or in states/territories
ASTDD Best Practices ProjectBest Practice Criteria
Collaboration / Integration Built effective partnerships/collaborations among various organizations and integrated oral health with other health projects and issues
Objectives / Rationale Addressed HP 2010 objectives, met the National Call to Action to Promote Oral Health, and/or built basic infrastructure and capacity for oral health programs
ASTDD Best Practices Project“Best Practice” Definition
“Best Practice” is a service, function or
process that has been fine-tuned, improved
and implemented to produce superior results
that demonstrate impact/effectiveness, efficiency,
sustainability, and collaboration/integration, with
appropriate objectives/rationale.
Best Practices forState & Local Oral Health Programs
Best Practices Applying the Science
Optimal oral health across the lifespan…
Best PracticeTranslate Research into Practice
■ Research evidence supporting the effectiveness & cost-effectiveness of a dental public health strategy
■ State of the science to design and implement programs and services
Why evidence?
■ Constant or diminishing resources require that public health programs focus on effective and efficient practices
■ “Evidence-based” approaches incorporate the best available scientific information into decision-making*
*Based on Sackett et al., BMJ 1996
Systematic Reviews
■ Preferred method for identifying available knowledge; determining what is “best”; and summarizing it in a useful manner*
■ Rule-based process reduces bias and error in reviewing and summarizing findings
Bader J et al., J Am Dent Assoc 2004;Mulrow C et al., American College of Physicians 1998
Process in Analyzing aBest Practice Approach
■ Describe the public health strategy
■ Evaluate the evidence for effectiveness and cost effectiveness of the strategy
■ Set initial review standards for Best Practice criteria
■ Learn from state/community practices that show successful implementation methods
In the Absence ofResearch Evidence
■ Realize that the intervention may or may not be effective
■ Review available information (e.g., related policies and position statements; theoretical rationale; consensus of expert opinion; descriptive data)
■ Identify and implement evaluative measures
■ Consider any unintended harms that could result from the intervention
ASTDD Best Practices ProjectUse of Evidence-Based Information
BP Project uses evidence-based information:
■ In analyzing a Best Practice Approach
■ In promoting its use for program development, implementation, and evaluation
■ In sharing state of the science information on the ASTDD Website
Best Practice ApproachEvaluation of Evidence
Promising Proven Approaches ............................……..........… Approaches
Strength of Evidence
Research + Research +++
Expert Opinion + Expert Opinion +++
Field Lessons + Field Lessons +++
Theoretical Rationale +++ Theoretical Rationale +++
A Best Practice Approach ReportA Best Practice Approach Report
Research Evidence
Summary of Research Evidence
Best Practices forState & Local Oral Health Programs
Best Practices Field Lessons & Support Network
Optimal oral health across the lifespan…
Successful PracticesProject’s Database
48 states and 2 territories provided submissions
230+ successful practices described
An expanding collection
Successful Practice DescriptionContent
History Justification Inputs, Activities, Outputs & Outcomes Budget Estimates Lessons Learned/Plans for Improvement Available Information Resources Best Practice Criteria Contact Persons for Inquiries
Successful Practice Descriptions
Nevada’s State Oral Health Plan
Ongoing and DynamicDevelopment of Best Practices
IdentifyBest Practices
Cultivate Best Practices
PromoteBest Practices
CollaborationIntegration
Science & Artof Successful
Implementation
Supportive Environment
Project’s Developing Role:Building a Supportive Environment
A support network
Partners’ support
Building of evidence
State of the science
Capacity building tools
Program & policy evaluation
Best Practices forState & Local Oral Health Programs
Using Best Practice toBuild Infrastructure & Capacity
Optimal oral health across the lifespan…
Build Infrastructure & Capacity
1999 ASTDD Project
State dental directors from 43 states participated
10 essential elements identified
Build Infrastructure & Capacity Essential Elements
Surveillance System
Leadership
State Plan
Policies
Communication & Education
Linkages / Partnerships
Population-based interventions
Community capacity Health systems
interventions Leveraging
resources
Best Practice Approach Reports
1. State Oral Health Surveillance System
2. State Oral Health Coalitions
3. State Oral Health Plans
4. Mandate for a State Oral Health Program
5. Community Water Fluoridation
6. School Sealant Programs
7. School Fluoride Programs
8. Workforce Development
9. Oral Health of Individuals with SHCN
Best Practice Approach Reports(continued)
10. Improving Children’s Oral Health through Coordinated School Health Programs (released March 2010)
11. Prevention and Control of Early Childhood Tooth Decay (released March 2010)
Building Infrastructure1999 to 2007 Comparison
State oral health surveillance systems 8 to 30 states
State oral health coalitions 20 to 41 states
State oral health plans 7 to 23 (33) states; 5 in development
Best Practices
ASTDD Best Practices Project
Optimal oral health across the lifespan…
The Journey Continues