Summary of Teams’ TISH Experiences and Results
| Team | Site Description | Change Ideas | Results | Reflection |
|---|---|---|---|---|
| The National Health Professions Commission (NHPC) Somaliland | A statutory body that mandates the regulation, accreditation, and licensing of health care professionals, health care facilities, and health training institutions in Somaliland, Africa | Longer first visits/consultations with patients to implement screenings More thorough oral health assessment in primary care setting Physician and dentist have telephone consultation over BP measurements, blood sugar levels, gingivitis Regular biweekly meetings to update the team and discuss weaknesses and strengths | Screened 100 patients (16.1%) for hypertension Referred 57 patients (9.9%) to primary care Screened 339 patients (89.9%) for gingivitis Referred 176 patients (46.7%) to dental care | “When patients come from their … physician and finally understand the importance of oral health, and they seek dental professionals for check-ups/treatment, it is truly a milestone!” |
| St Barnabas Hospital (SBH) Health System | A teaching hospital with medical and dental residency programs | Education of residents and assistants Medical team evaluates patient initially using the questionnaire and the examination follows Reinforced team cooperativity by presenting a virtual meeting to residents and attendings about progress Developed the spreadsheets on teams so data can be seen by everyone | Screened 861 patients (100%) for hypertension Referred 83 patients (9.6%) to primary care | “Created an awareness of the impact of dental health on overall health” |
| St Mary’s Medical Center Family Medicine Residency Program | A patient-centered medical home with a focus on training physicians for rural practice; the team partnered with a nearby health center to provide dental services | Begin incorporating gingivitis screen into well-person examinations in adults; results are recorded in the chart Set up referrals to dental partners in Epic to streamline referral process | Screened 409 patients (92.1%) for hypertension Referred 59 patients (13.3%) to primary care Screened 58 patients (63.0%) for gingivitis Referred 11 patients (11.9%) to dental care | “Watching our dental examination numbers and referral numbers improve from zero, showing that we’re starting to take oral health more seriously in our clinic, and that we now have dental partners to help us do better in this goal” |
| Tiburcio Vasquez Health Center (TVHC) | A Federally Qualified Health Center providing comprehensive medical and dental services | Access to working BP kits in dental operatories; staff are educated on hypertension guidelines Warm hand-off to medical team if BP >160/110 mm Hg Education and training for medical team Trackable and streamlined referral process between dental and medical teams | Referred 557 patients (14.7%) to primary care | “Medical-to-dental process is now so much swifter for adult patients who need to be seen, increased Epic connectivity between the 2 disciplines.” |
| Pacific Dental Services | A dental support organization with a focus on raising awareness of the link between oral health and overall health on a national scale | Dental front office has patient complete questionnaire at check-in Front office, medical assistants, and dental assistant coordinate to schedule referral appointments while patient still in dental chair or medical examination room Improved EHR referral and launched referral-tracking dashboard Altered marketing material in the medical and dental settings | Referred 114 patients (6.0%) to primary care Referred 287 patients (17.5%) to dental care | “We have had some big wins in getting dental to engage in the referral process with minimal added lift to improve bidirectional flow and the level of care being provided to patients.” |
| The Partners in Integrated Care (PIC) Place | A nonprofit organization offering medical, dental, vision, and behavioral health services | Train dental staff to take manual BP measurements “Summer Smackdown” to incentivize staff to make cross-discipline referrals; involve staff in the data collection process Implemented checklists for medical team to remember oral screening | Referred 43 patients (2.8%) to primary care Referred 89 patients (7.6%) to dental care | “Summer Smackdown winners really put forth effort in creating referrals and thrived under the positive incentives and recognition.” |
| Harvard Dental Center | An academic dental clinic with faculty professionals | BP measured at every patient visit Dental assistant takes and records BP at the start of every visit in AxiUm and Excel sheet | Screened 83% of patients for hypertension | “The workflow between a dentist and dental assistant is like doing a dance. This team started working together just 1 month before TISH. TISH helped establish the footwork for at least one part of the clinic workflow. We’re proud to say that we’re now dancing!” |
| Cambridge Health Alliance (CHA) | A safety net hospital system with a dental center | Studied criteria and process for dental-to-medical referral by tracking hypertension screenings and the action taken by provider Train dental users on Epic | Screened 158 patients for hypertension Counseled 23% of patients with stage 2 hypertension | “Learning what upstream resources our organization has to address structural determinants to health and how they can be applied in the dental setting” |
BP = blood pressure; EHR = electronic health record; TISH = Teaming and Integrating for Smiles and Health.