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MCN Referral Managementand development of Surgical Dental Service
Maggie LeggateClinical effectiveness advisor
Pittodrie Stadium 2012MCN Oral Health and Dentistry event
7th Feb 2012
Terry LoweConsultant OMFS
Referral Management subgroup
OriginFeedback from 1’ care practitionersSecondary care audit;
Quality and effectiveness of referral processSecondary care service redesignGovernment targetsGovernance/Good medical practice
‘Meet the consultants evening’ - 2009
Objectives
Improve the overall quality of referralsTriagablePromote best practice in referral managementFacilitate administration
Improve communication/feedback
Better utilisation of resources
Process
Identified stakeholders for each group Regular meetings
Each service provided referral criteria Standard template produced.
Orthodontics formed own referral working group
Result
Guidance Document
Referral forms for each specialty
Piloted; ten primary care practices
First edition distributed June 2011
More recently….
Document handed to Dental Advice and Referral Centre (DARC)
Islands Highland
Website support - HI- Net Grampian
Benefits
Pre- and post guidance audit ;
Quality of Referrals to OMFS
Data collection; Both administrative and clinical parameters to
assess the overall quality of the referral
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Patient'sDate of
Birth
Patient'sCHI
Number
Address Postcode Contacttelephonenumber
Referrer'sname orpractice
Referrer'saddress
Identification Data
New
OLd
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Adequatehistory
Referralrequest clear
Provisionaldiagnosis?
Is the degreeof urgencyindicated?
Photographattached?
Radiographattached?
Radiographdiagnostic?
Clinical Details
New
Old
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Medicalhistory
recorded?
Allergies Medication? SmokingStatus
Alcohol? SocialHistory ?
Medical History
New
Old
Summary Development of referral guidance - ongoing
Inclusion, networking, establishing clarity
Updateable, dynamic resource on line
- accessible to all
Support for practitioners
Greater understanding of care pathways
Establish electronic referrals – SCI Gateway
Primary Care Surgical Dentistry Service
Primary care Surgical Dentistry service
OMFS audits 2009/11; 6-10% activity suitable for
primary care surgery(LA)
Minor O/P surgery for remote & rural location
Successful model in Islands for many years
Postgraduate Diploma/ MSc in O/S; UCLAN
Extrapolate to provide Intermediate care pathway
for Surgical Dentistry
Members…so far
Archana Kavi (ABD) – MSc , UCLAN Andrew McIntosh (ABD) Bernice McLaughlin (ABD) Charlotte Nash (Moray)
Islands Pippa Arbon (Shetland Isles) Dip, UCLAN Nigel Pendry (Orkney)
Activity
Minor dentoalveolar surgery/LA GA exts list RACH/ support from OMFS
Criteria
ASA I/II Extractions, retained roots MOS ; soft tissue/ mod. bone removal Apicectomy of single rooted teeth with appropriate
presurgical endodontics
Where next…
First echelon training completed Top up training support available.
Training for Dental Students.
Service redesign in Moray – supporting primary care practitioners.
Dental anxiety management/sedation service
Thank you