{"id":17,"date":"2017-11-13T13:12:19","date_gmt":"2017-11-13T13:12:19","guid":{"rendered":"https:\/\/sites.udmercy.edu\/pa161\/?page_id=17"},"modified":"2018-05-16T15:55:39","modified_gmt":"2018-05-16T15:55:39","slug":"home","status":"publish","type":"page","link":"https:\/\/sites.udmercy.edu\/pa161\/","title":{"rendered":"About"},"content":{"rendered":"

Oral Health is Important to Pregnancy<\/h1>\n

The Michigan Maternal and Infant Oral Health Project (MIMI-OH), funded by the Michigan Department of Health and Human Services (MDHHS), integrates registered dental hygienists (RDH) within an obstetric setting to provide care efficiently as part of an inter-professional team.\u00a0 This project is a coordinated partnership involving the University of Detroit Mercy, the MDHHS Oral Health Program, and the Michigan Primary Care Association.\u00a0 Grace Health was our model site and clinical consultants.<\/p>\n

Improving Workflow<\/h2>\n

How can we provide more dental assessments for pregnant women?<\/p>\n

“Incorporating a dental assessment into either the intake appointment and\/or the first physical would definitely increase the number of assessments and save hygienists a lot of leg work.\u00a0 However, the known barrier of limited time remains an issue.\u00a0 Some providers find that the length of the intake visit is already long, leading to the perception that adding a dental assessment to those visits would add too much time to the patients’ appointments.\u00a0 Usually, the hygienist greets the patients in the waiting room or exam room and introduces herself and the oral health services offered through this program.\u00a0 After the introduction and patient education, hygienists have been scheduling out the next prenatal visit along with either an hour or \u00bd hour hygiene visit as patients walk out the door.” – Stacy Hofmeister, RDH, Ingham County<\/p><\/blockquote>\n

How can we improve access to dental care for pregnant women?<\/p>\n

“I am educating and referring every single patient every single time.” – Staci Hard, RDH, Grace Health<\/p><\/blockquote>\n

Initial Pilot Site Impact<\/h2>\n

As of mid-May 2018, our 5 active pilot sites reported seeing 729 pregnant patients, measured through Patient Education provision (D1330).\u00a0 Of those, 69% received an Oral Assessment (D0191) and 58% were referred to a dentist.<\/p>\n

The project officially launched in Oct-2017 when Dr. John Girdwod was hired as the statewide program manager.\u00a0 Data for Oct-2017 through Dec-2017 were reported solely from Grace Health, our model pilot site, whose Registered Dental Hygienist (RDH) logs about 24 hrs\/wk during a normal month.\u00a0 This equates to a benchmark, measured in Oct-2017, of 1.8 hours of dedicated RDH work time per patient.\u00a0 We will measure that again for all sites at the end of the grant period to look for any changes or trends.<\/p>\n

By our 6th month (Mar-2018), our 5 active sites averaged just over 33 patients per month, measured by the count of D1330 Patient Education provided to patients.\u00a0 This is exactly how many patients Grace Health’s RDH saw on average, per month, during our first 3 months.\u00a0 During subsequent months, we will examine the feasibility of seeing > 33 patients per month at each site.<\/p>\n

Click here for more information about our sites<\/a>!<\/p>\n

Pilot Site Performance<\/h1>\n

This project began in Fall 2017 with the goal of implementing oral health services at 6 pilot sites throughout Michigan.\u00a0 Although our sites share similarities, e.g. they are all FQHCs, they function a little differently across the state.\u00a0 We tried to standardize work when we could, but we emphasized each site’s strengths so that shared knowledge would help improve workflow.<\/p>\n

The following snippets include some data and are meant to convey narratives, or “tell the story,” about how sites implemented this MDI project in their clinic.<\/p>\n

Grace Health<\/h2>\n

Our model pilot site, Grace Health in Battle Creek, set the tone for this project.\u00a0 Their site RDH, Staci Hard, is employed part-time at 24 hrs\/week so we examined initial benchmark KPI off that knowledge.<\/p>\n

\"2018-05<\/a>
2018-05 Grace Data Chart<\/figcaption><\/figure>\n

The strengths at Grace Health are (1) stability of the project; (2) cultural integration; and (3) every patient is referred to a dental home.\u00a0 Referrals are structurally fluid due to the dental clinic’s close proximity (a matter of feet) to the OBGYN clinic and culturally successful because Staci Hard, RDH has made referrals standard work.<\/p>\n

Ingham County Health Department<\/h2>\n

Our model government-run health clinic, Ingham County Health Department Women’s Clinic, launched somewhat late in the 1-year grant timeline but immediately began maximizing the hygienist’s time, serving the most patients of any site employing a full-time hygienist.<\/p>\n

\"2018-05<\/a>
2018-05 Ingham Data Chart<\/figcaption><\/figure>\n

The strengths at Ingham County are (1) maximized RDH time; (2) cultural integration; (3) ability to provide patient care like prophylaxis and fluoride varnish; and (4) integrated OBGYN and PED care.\u00a0 Integrated PED care is structurally fluid due to the dental clinic’s close proximity (a matter of feet) to the PED clinic and culturally successful because Stacy Hofmeister, RDH has made seeking PED patients standard work.\u00a0 Additionally, Connie Crowe supervises both PED and OBGYN clinics so there is universal oversight of care for both pregnant women and children, involving the entire family as a unit of care.<\/p>\n

Great Lakes Bay Health Center<\/h2>\n

Our model stand-alone health clinic, Great Lakes Bay Health Center, launched somewhat late in the 1-year grant timeline but immediately began making quality improvements as shown by the upward trend each month in patient care.<\/p>\n

\"2018-05<\/a>
2018-05 Bay City Data Chart<\/figcaption><\/figure>\n

The strengths at Great Lakes Bay Health are (1) continuous improvement and (2) cultural integration.\u00a0 Continuous improvement is supported by Paul Crowley, DDS, who makes regular trips from the health system’s off-site dental clinic to the OBGYN health center.\u00a0 Additionally, Leanne Jordan, RDH works diligently to think of new ways to reach patients like placing a “DENTAL” sign outside the room door, adding posters throughout the clinic to promote the program, and seeking micro-time slots during which she can see patients.\u00a0 She locates available patients who are waiting in empty clinical rooms through a room flag system.\u00a0 Cultural integration is supported by Doug Saylor, MD, who is both Medical Director for the health system and an OBGYN physician.<\/p>\n

Promoting Oral Health During Pregnancy<\/h2>\n

Click here for\u00a0PDF of all the poster images you see below<\/a> or\u00a0click on each individual image to get a high resolution JPEG of that image.\u00a0 Questions about use should be directed to Dr. John Girdwood, Statewide Project Director at girdwojr(at)udmercy(dot)edu.\u00a0 Free to use and copy for all project sites!<\/em><\/p>\n

\"Oral<\/a>
Oral Health is Important to Pregnancy – Maternal and Infant Oral Health<\/figcaption><\/figure>\n

The Michigan Maternal and Infant Oral Health (“MIMI-OH”) project was launched in 2017 and has continued to grow statewide.\u00a0 Our goal is to improve oral health outcomes for mothers and infants through quality medical-dental integration.\u00a0 We define quality care as being safe, timely, effective, efficient, equitable, and patient-centered.\u00a0 Our project places a\u00a0Registered Dental Hygienist<\/strong> into an\u00a0OBGYN medical clinic<\/strong> through Michigan’s PA161 program<\/a>.\u00a0 We have sites in Bay City, Benton Harbor, Muskegon, Battle Creek, Lansing, and the Upper Peninsula.<\/p>\n

\"Mimi<\/a>
Mimi protects her unborn baby – Maternal and Infant Oral Health<\/figcaption><\/figure>\n

Initial Impact (Documented)<\/h2>\n