Quality Improvement & Program Evaluation

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Continuous Quality Improvement (CQI) and program evaluation are essential to any initiative to enable stakeholders to ensure accountability, optimize resource allocation, and facilitate buy-in for future programming and growth. CQI is a deliberate process of reviewing findings and providing feedback on needed changes to increase the effectiveness of and strengthen programmatic initiatives.   

 Quality Improvement (QI) and Program Evaluation:

  • Ensure Effectiveness: the programs achieve their intended goals.
  • Identify Areas for Improvement: through systematic evaluation processes, identify areas where the program may need improvement.
  • Learn and Adapt: facilitate learning and adaptation by providing insights into what works and what doesn’t and showcasing potential paths to change.
  • Demonstrate Impact: provide evidence of the program’s impact, which is essential for securing continued funding and support from both the schools and families.

Qualitative and Quantitative Data Collection for Evaluation

  • Tracking the frequency and type of teledentistry services provided
  • The number of patients that return for an in-person visit following teledentistry
  • The number of referrals provided
  • Patient satisfaction surveys
  • Provider satisfaction survey
  • Demographic data
  • Consent forms by the school (distributed, collected, and returned)
  • Patient stories
  • Barriers and successes
  • Unduplicated patients
  • Duplicated patient services during a teledentistry visit
  • Duplicated patient services following a teledentistry visit (in-person)
  • Continuous process improvement using the aim statement as a baseline

Develop a patient/parent/guardian and provider (school nurse) surveys to assess the target population’s oral health knowledge and identify knowledge or resource gaps. The information will guide the implementation of specific strategies to remedy those gaps.

Quality improvement

Participants engage in Continuous Quality Improvement (CQI) to develop and implement CQI activities. The CQI activities will gather data on small potential changes to program processes that are critical to work plan activities, ensuring that they are implemented with fidelity and that barriers are identified and addressed. The “Plan, Do, Study, Act” (PDSA) cycle will be the basic format of this CQI activity, with lessons learned from each iteration built into the next successive step.

A high-touch technical assistance methodology focused on integrating effective clinical and community-based strategies increases the program’s success. Through a collaborative learning platform, safety-net clinic teams can develop a network for connection that promotes partnerships and collective efforts to optimize resources and achieve sustained improvements in oral health.

When working toward a shared vision, utilizing QI methods, testing innovative strategies, and sharing ideas, results, and learnings with key stakeholders can help accomplish system-level change. Multidisciplinary teams work together to tackle a common problem, including measurable improvement in a common aim and learning about innovations to achieve a shared vision. The team should create a shared vision, aims, change package, measurement strategy, and PDSA cycles.

Quality improvement should follow five steps:

1. Define your vision and purpose

2. Set your aims and goals

3. Develop measures

4. Begin intervention/PDSA

5. Review, revise, and start again

QI tools like process mapping and root cause analysis can help your clinic team assess how well teledentistry works for providers and patients and identify areas for improvement. The resources section at the end provides additional information about the QI process. Evaluating your teledentistry program will reveal whether it has the intended impact on your patient population.

  1. Create a QI infrastructure to meet individual team needs:
    • Define the vision and purpose
  2. Design measurable and SMARTIE aim statements
    • Develop measures
  3. Begin intervention and PDSA

One can utilize many methods and tools when engaging in quality improvement and program evaluation. Below are just a few examples of these tools, but each clinic would benefit from researching and trialing which item works best for their pilot programming.

This project is supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services as part of a Health Resources and Services Administration Oral Health Work Force Grant awarded to the Virginia Department of Health (Project Period 09/01/2022 – 08/31/2026). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government.