Upload
maxisurgeon
View
410
Download
4
Tags:
Embed Size (px)
Citation preview
Service Learning Collaboration &Service Learning Collaboration &The Integration of The Integration of
Lutheran Medical CenterLutheran Medical CenterPostdoctoral Residency Training Postdoctoral Residency Training Programs in Community Health Programs in Community Health
CentersCenters
Neal Demby, DMD, MPHNeal Demby, DMD, MPHDirector, Dept of Dental MedicineDirector, Dept of Dental Medicine
Anna D’Emilio, DDSAnna D’Emilio, DDSDirector, AEGD ProgramDirector, AEGD Program
Bernard Tolpin, DDS, MPHAssociate Director, Dept of Dental
Medicine
Susan Dietrich, DDSDirector, Graduate Dental Education
Lutheran Medical CenterLutheran Medical Center
476 + bed teaching hospital476 + bed teaching hospital
Level 1 Trauma CenterLevel 1 Trauma Center
Only hospital-based CHC (Federally qualified health Only hospital-based CHC (Federally qualified health center) in the countrycenter) in the country
600,000+ encounters at main site600,000+ encounters at main site
75,000+ dental encounters at main site75,000+ dental encounters at main site
120,000+ dental encounters at extramural partnership 120,000+ dental encounters at extramural partnership sitessites
Culturally Diverse PopulationsCulturally Diverse Populations
Service Learning MissionService Learning Mission
Recruitment & retention of oral health providers Recruitment & retention of oral health providers remains a critical and chronic problem in assuring remains a critical and chronic problem in assuring access to care; centers face challenges with workforce access to care; centers face challenges with workforce and budgets.and budgets.
Through the establishment of creative, collaborative Through the establishment of creative, collaborative partnerships between LMC dental education programs partnerships between LMC dental education programs and community health centers, a major workforce and community health centers, a major workforce initiative has been put in place to develop a cost initiative has been put in place to develop a cost effective means for centers to ameliorate access issues effective means for centers to ameliorate access issues for the most vulnerable . for the most vulnerable .
Health centers have the resources to provide the Health centers have the resources to provide the learning/educational environment to new dentists.learning/educational environment to new dentists.
Collaboration AdvantagesCollaboration Advantages
LMC pays resident salary & benefitsLMC pays resident salary & benefitsLMC provides financial reimbursement to LMC provides financial reimbursement to
sites for administrative timesites for administrative timeSite retains all income generated by the Site retains all income generated by the
residentresidentLMC consultant faculty appointmentLMC consultant faculty appointmentCE opportunities; faculty developmentCE opportunities; faculty developmentADA accreditation of clinical training siteADA accreditation of clinical training siteRecruitment and retention of providersRecruitment and retention of providers
““Win-win situation”Win-win situation”
Collaborative PartnershipsCollaborative Partnerships
Community Health Community Health Centers (FQHCs)Centers (FQHCs)
Public Health Public Health DepartmentsDepartments
Indian Health ServicesIndian Health Services Group practices (profit & Group practices (profit &
non-profit)non-profit) Health Science CentersHealth Science Centers
Managed Care Managed Care OrganizationsOrganizations
Veterans AdministrationVeterans Administration Community HospitalsCommunity Hospitals Health DepartmentsHealth Departments AHECAHEC Prison Health SystemsPrison Health Systems
PRIMARY CARE DENTAL RESIDENCY
(Initial Program Yr)
ADA COMMISSION ON
DENTAL ACCREDIATION(Latest approval)
LENGTH OF PROGRAM
NUMBER OF
RESIDENTS
ENROLLED
2008-2009
GENERAL PRACTICE RESIDENCY (GPR)
1974
APPROVAL2002
1 YEAROPTIONAL 2ND
YEAR11
ADVANCED EDUCATION IN GENERAL DENTISTRY
(AEGD)1988
APPROVAL2006
1 YEAROPTIONAL 2ND
YEAR
73
ADVANCED EDUCATION IN PEDIATRIC DENTISTRY
1994APPROVAL
20022 YEARS
26
ADVANCED EDUCATION IN ENDODONTICS
2004
APPROVAL2007
2 YEARS 6
DENTAL ANESTHESIOLOGY2008
INITIAL ACCREDITATION
20082 YEARS 8
LMC Program & Partnership LMC Program & Partnership EvolutionEvolution
AEGD ProgramAEGD Program
19881988
1 resident; 1 site1 resident; 1 site
20082008
73 residents; 61 sites73 residents; 61 sites
PEDS ProgramPEDS Program
19941994
2 residents; 1 site2 residents; 1 site
20082008
26 residents; 3 sites26 residents; 3 sites
Current States: Alaska, Arizona, California, Colorado, Hawaii, Massachusetts, Maryland, Michigan, Mississippi, New
Mexico, New York, Rhode Island, Tennessee
Future: New Jersey, Oregon, Connecticut, New Hampshire
Lutheran Medical Center Dental Residency Network
ALA
SK
A
Yukon-Kuskokwin Health Bethel, Alaska
AR
IZO
NA
Mountain Park Health Center 635 East Baseline Road Phoenix, Arizona 85042 AEGD Residents
El Rio Health Center Northwest 4009 N Flowing Wells Tucson, Arizona 86705 AEGD Residents
North Country CHC Flagstaff, Arizona AEGD Residents
Winslow Indian Health Center Winslow, Arizona AEGD Residents
Sells Indian Health Service AEGD Residents
Mariposa Community Health Center 1852 N
Mastick Way Nogales, Arizona 85621
AEGD Residents
Dental Net 1057 N Kolb Road Tucson Arizona 85710 AEGD Residents
Sun Life Family HC 865 N Arizona Road Casa Grande, AZ 85222 AEGD Residents
Dental Net 4747 N 7th Street Phoenix, Arizona AEGD Residents
Dental Net 5905 W Bell Road Glendale, Arizona 85308 AEGD Residents
El Rio Health Center Southwest 1530 Commerce Street Tucson, Arizona 85746 AEGD Residents
Pascua Yaqui Tribal Dental Center 7490 S. Camino De Oeste Tucson, Arizona 85746 AEGD Residents
EL Rio Health Center Downtown 639 W Congress Street Tucson, Arizona 85745 AEGD Residents
CO
LO
RA
DO
Marillac Clinic Grand Junction, Colorado AEGD Residents
Valley Wide Health Center 186 Hurt Street Center. Colorado AEGD Residents
Valley Health Center 204 Carson Avenue Alamosa, Colorado 81101 AEGD Residents
Valley Health Center 375 East Park Avenue Durango, Colorado 81301 AEGD Residents
HA
WA
IIA
N I
SLA
ND
S
Keaau Family Health Center Dental Clinic 16-192 Pilimua Street Keaau, Hawaii 96749 AEGD Residents
Maui Oral Health Initiative 310 W Kaahumanu Avenue Kahuliu, Hawaii 96732 AEGD Residents
Kokua Kalihi Valley 2239 N School Street Honolulu, Hawaii 96819 AEGD Residents
Kalhi-Palama HC 915 N King Street Honolulu, HI 96817 AEGD Residents
Kaua’I Community Health Center 4643 Waimea Canyon Drive Waimea, Hawaii 96796 AEGD Residents
Waianae Coast Comprehensive HC 86-260 Farrington Highway Waianae, Oahu, Hawaii 96792 AEGD Residents
BO
STO
N M
AS
SA
CH
US
ETTS South Cove Community HC
885 Washington Street Boston, MA 02111 AEGD Residents
South Cove Quincy 275 Hancock Street Quincy, MA 02171 AEGD Residents
Codman Square Health Cener Washington Street Dorchester, MA 02124 AEGD Residents
Harvard Street Health Center Blue Hill Avenue Dorchester, MA 02124 AEGD Residents
Dorchester House Health Center 1353 Dorchester Avenue Dorchester, MA 02122 AEGD Residents
Dimock Community Health Center 55 Dimock Street Roxbury, MA 02119 AEGD Residents
Whittier Street HC 1125 Tremont Street Roxbury, MA 02120 AEGD Residents
Boston Public Oral Health 774 Albany Street Roxbury, MA 02118 AEGD Residents
Joseph M Smith Family Health Center 287 Western Avenue Alston, MA 02134 AEGD Residents
NEW
MEX
ICO
Indian Health Service Dental Clinic Albuquerque, NM AEGD Residents
Acomo-Canoncito-Laguna Indian Health Service Grants, NM AEGD Residents
Santa Fe Indian Health Service Hospital 1700 Cerrillos Road Santa Fe, NM 87505 AEGD Residents
METR
OP
OLIT
AN
NY
AR
EA
Sunset Park Family Health Center 150 55th Street Brooklyn NY 11220 AEGD Residents
Morris Heights Health Center 85 W Burnside Avenue Bronx, NY 10453 AEGD Residents
Callen Lorde Community Health Center 356 W 18 Street New York, NY 10011 AEGD Residents
Bedford-Stuyvesant Family Health Center 1413 Fulton Street Brooklyn, NY 11216 AEGD Residents
Joseph P Addabbo Family Health Center 67 Rockaway Beach Blve. Arverne, NY 11692 AEGD Residents
Brooklyn Chinese Family Health Center 812 54th Street Brooklyn, NY 11220 AEGD Residents
Park Ridge Family Health Center 6317 4th Avenue Brooklyn, NY 11220 AEGD Residents
Peekskill/Hudson River Health Center 1037 Main Street Peekskill, NY 10566 AEGD Residents
CA
PIT
AL D
ISTR
ICT U
PS
TA
TE N
Y
Schenectady FHS 602 Craig St. Schenectady, NY 12307 AEGD Residents
1st Advantage Dental 1202 Troy, Schenectady Rd, Latham, NY 12110 AEGD Residents
Whitney Young FHC Lark Dr. & Arbor Dr. Albany, NY 12210 AEGD Residents
PR
OV
IDEN
CE R
HO
DE I
SLA
ND
St. Joseph Hospital 21 Peace Street Providence, RI Pediatric Residency Program
TENNESSEE
Implementing an LMC Program Implementing an LMC Program at a Clinical Training Siteat a Clinical Training Site
Site complies with ADA standards & program Site complies with ADA standards & program curriculum, including but not limited to:curriculum, including but not limited to:
Identify dentists who will provide clinical supervision of Identify dentists who will provide clinical supervision of residentsresidents
Provide practice resources (auxiliaries, supplies, room, Provide practice resources (auxiliaries, supplies, room, etc.)etc.)
Provide the required clinical experiences*Provide the required clinical experiences* Evaluate clinical competency**Evaluate clinical competency** Provide support for didactic curriculum (resident Provide support for didactic curriculum (resident
schedule, cases, internet access, work space, etc.)schedule, cases, internet access, work space, etc.) Include resident in QA program (chart audits, meetings, Include resident in QA program (chart audits, meetings,
etc.)etc.)Sites can collaborate together to share resident(s) or Sites can collaborate together to share resident(s) or
provide additional rotations/experiencesprovide additional rotations/experiences
*Required Clinical Experiences*Required Clinical Experiences
Comprehensive Comprehensive multidisciplinary dental multidisciplinary dental carecare
Patient assessment and Patient assessment and diagnosisdiagnosis
Obtaining informed consentObtaining informed consent Promoting disease Promoting disease
preventionprevention Control of pain & anxiety Control of pain & anxiety
(behavior & (behavior & pharmacological)pharmacological)
Restoration of teeth Restoration of teeth (including single crowns)(including single crowns)
Replacement of teeth Replacement of teeth (fixed partial dentures, (fixed partial dentures, removable partial dentures removable partial dentures and complete denturesand complete dentures
Periodontal therapy Periodontal therapy (including surgery)(including surgery)
Endodontic therapy Endodontic therapy (including molar endo)(including molar endo)
Hard and soft tissue Hard and soft tissue surgerysurgery
Management of medical Management of medical and dental emergenciesand dental emergencies
Medical risk assessmentMedical risk assessment
**Online Evaluation/Outcomes **Online Evaluation/Outcomes Assessment ApplicationsAssessment Applications
Didactic CurriculumDidactic Curriculum
Provided by LMCProvided by LMCApplications of distance learning Applications of distance learning
within post doctoral dental education within post doctoral dental education Synchronous Learning via Synchronous Learning via
Video teleconferencing Video teleconferencingAsynchronous Learning via web-based Asynchronous Learning via web-based
applicationsapplicationsRegional EducationRegional Education
Growth of distance learning via Growth of distance learning via
video teleconferencingvideo teleconferencing
1994 1994 20 residents, 2 didactic sites20 residents, 2 didactic sites
(14 years later)(14 years later)
20082008118 residents, 24 didactic sites, 64 CHCs118 residents, 24 didactic sites, 64 CHCs
Requirements for Distance LearningRequirements for Distance Learning
Identify a didactic site for the region or islandsIdentify a didactic site for the region or islandsPurchase equipment or utilize a local network Purchase equipment or utilize a local network
sitesiteLMC uses a bridging service – ExpediteLMC uses a bridging service – ExpediteExpediteExpedite
Performs test calls with new didactic sitePerforms test calls with new didactic siteConnects all sites for VTC sessionsConnects all sites for VTC sessions
Weekly confirmation of connection timesWeekly confirmation of connection timesFacilitator – one or more dentists at each didactic Facilitator – one or more dentists at each didactic
site for weekly didactic sessions (assistant site for weekly didactic sessions (assistant director + site faculty)director + site faculty)
Video Teleconferencing Sites
Honolulu HIHonolulu HITucson AZTucson AZ
Winslow AZWinslow AZ
Ocala FLOcala FL
Albany NYAlbany NYBrooklyn NYBrooklyn NY
Providence Providence RIRI
Boston MABoston MA
Alamosa COAlamosa CO
Maui HIMaui HI
Anchorage AKAnchorage AK
Memphis TNMemphis TN
Keaau HIKeaau HI
Bethel AKBethel AK
Juneau, AKJuneau, AK
Eastern Eastern Shore MDShore MD
Holyoke MAHolyoke MA
Meridian MSMeridian MSGallup NMGallup NM
Mesa AZMesa AZ
Jackson MIJackson MI
Oakland CAOakland CA
Redding CARedding CA
San Juan PRSan Juan PR
Columbia University School of Dental Medicine AT Still University/ ASDOH University of the Pacific Boston University University of Arizona Northern Arizona University University of Rochester/ Eastman Dental Center University of Missouri – Kansas City Hawaii Primary Care Association Penn State University – Hershey Idaho State University – Pocatello New York State OMRDD Marquette University Kaiser-Permanente Syracuse Medical Center
Telecommunication NetworkTelecommunication Network
Typical Week of a ResidentTypical Week of a Resident
MONDAYMONDAY TUESDAYTUESDAY WEDNESDAYWEDNESDAY THURSDAYTHURSDAY FRIDAYFRIDAY
CLINICCLINIC
ALL ALL DAYDAY
AMAMCLINICCLINIC
1–5 PM – VTC/1–5 PM – VTC/DIDACTICSDIDACTICS
CLINICCLINIC
ALL ALL DAYDAY
CLINICCLINIC
ALL ALL DAYDAY
CLINICCLINIC
ALL ALL DAYDAY
Resident assignment to Saturday sessions are permitted with faculty supervision.
Creative scheduling allowed providing there’s supervision and resident has minimum 40 hours devoted to the entire program.
VTC based on EST; therefore allow for different starting times in other time zones – lecture may start in AM session
ConclusionConclusion
These pivotal elements describe how These pivotal elements describe how vision, health policy, innovative ideas, vision, health policy, innovative ideas, can be translated to a major workforce can be translated to a major workforce program that increases access to program that increases access to services for the underserved, while services for the underserved, while maintaining an educational commitment maintaining an educational commitment to equity and service learning in to equity and service learning in postdoctoral education.postdoctoral education.
ContactsContacts
Susan Dietrich, DDSSusan Dietrich, DDS
Director, Graduate Dental EducationDirector, Graduate Dental Education
Phone: 646. 413. 8846Phone: 646. 413. 8846
Email: Email: [email protected]@gmail.com
Anna D’ Emilio, DDSAnna D’ Emilio, DDS
Director, AEGD ProgramDirector, AEGD Program
Phone: 718. 630. 7213Phone: 718. 630. 7213
Email: Email: [email protected]@lmcmc.com