Quality Matters

This unique book considers the concept of quality as it relates to the provision of dental care. For the author’s purposes, quality is defined in relation to the process of care, the service given, the people delivering the care, and the environment in which the care is provided. In each of these various facets of dental care, the author considers the process of measuring, assessing, improving, and monitoring quality and its impact on the way we work and live.

Contents

1. Introduction
2. The meaning of quality
3. Quality Concepts
4. The challenge of measurement
5. Continuous Quality Improvement
6. Clinical Audit
7. Clinical Governance
8. Evidence-based dentistry
9. Service Quality
10. Business Implications

Foreword

One of the primary concerns of patients is quality of care. Today, quality of care, as considered in this most welcome addition to the now substantial Quintessentials series, is a broad concept, embracing all aspects of the patient experience. In this carefully crafted book, Dr Rattan aims to help colleagues better understand how to satisfy, and wherever possible exceed, patients’ ever increasing expectations of quality of care. The aims and objectives of the book have been surpassed through Dr Rattan’s skilful consideration of the relevant theory and his authoritative approach to the necessary attitudes towards quality and quality improvement to optimise the delivery of care in the clinical practice of dentistry. Quality Matters: From Clinical Care to Customer Service is an engaging, easy-to-read text, peppered with advice and guidance of immediate practical relevance. Understanding and applying the many interrelated aspects of quality of care should be considered an integral element of professional ethics and professionalism, as viewed in our changing society. As such, Quality Matters: From Clinical Care to Customer Service should be essential reading for all those with limited knowledge of quality issues in oral healthcare provision. Moreover, and in common with Dr Rattan’s other books in the Quintessentials series, this book includes numerous pearls of wisdom for even the most experienced of practitioners. The few hours necessary to read and digest this concise, thought-provoking book, will be time well spent. What good is care that lacks quality?

Nairn Wilson
Editor-in-Chief

Preface

The challenge of writing this book was a challenge of interpretation. How should I interpret the term quality? Narrowly defined, quality refers to the clinical outputs - periodontal treatment, crowns and bridges, simple and complex restorations, and so on. A broader interpretation would include the quality of the process of care, the quality of the service, the quality of people delivering the care, and the quality of the environment in which the care was provided. Each of these facets is in itself an aggregate of smaller components, so how far to explore each individual component? I have chosen to taken the broadest view on quality and include elements that I believe to be relevant to general dental practice. There is more to quality than implementing a system or working towards a given standard; it is about an attitude of mind that makes us want to improve the way we work and live. Attitude is the fuel of ambition. Throughout this book, I have referred to users of our services as patients. It has fashionable to talk about “customers” and “clients” in dentistry, but the use of these terms have been used only where they appear in verbatim citations from other texts. To serve a patient is a privilege bestowed only to healthcare workers; it embraces all the desirable elements important to “clients” and “customers” but also includes the unique ethical attributes associated with healthcare. The reader should be aware of one omission from this text. It relates to an important facet of quality and that is risk management and patient safety. This subject has been covered in depth in a previous book in this series - Risk Management in General Dental Practice. Professor John Øvretveit, of the Karolinska Institute Medical Management Centre, Stockholm, is a respected authority on quality in healthcare. His view “that a quality system is based on underlying theory about what needs to be done to provide a quality service” has influenced the structure of this text. The theory is important—it drives the implementation of quality initiatives in the context of our own working environment. If we wanted to build a car engine, we would need to know and understand the theory behind the design. We would welcome information on how others have approached engine design and we would ask for guidance on how and where to begin. That is what I have aimed to do in this book. The value of the theory, ideas and examples is only realised when the rubber hits the road. That remains the driver’s responsibility.