Five Dimensions of Success for Oral Health Programs

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We are asked all the time to help define what success should and could look like in Federally Qualified Health Center (“FQHC”) dental programs.  Administrators who want to provide the right infrastructure and support to the dental department are interested in how to define success, as are the dental directors and practice managers charged with achieving clinical and operational efficiency.  To help better understand where to look when defining success, we focus on these five dimensions:

  1. Access
  2. Finance
  3. Outcomes
  4. Quality
  5. Governance 

ACCESS in dental, like medical, is defined on one level by the number of visits.  However, access also includes what happens in the visit- the services provided, how much happens, and who it happens to.  Meaningful and measurable operational goals should therefore include the number of visits, number of services provided, types of services provided, patient mix and payer mix.

In the dimension of FINANCE, it is important to have a responsible plan for the sustainability and viability of the dental program.  The plan should include all revenue sources, direct and indirect expenses, and financing mechanisms that support the growth and operating goals of the practice and the health center as a whole. 

Improved health OUTCOMES are a critical component of the oral health program’s success.  Operating and clinical policies should align with credible evidence-based practices, and each patient’s oral health status should be measured at each visit in order to track outcomes over time.

While QUALITY measures should be a component of any healthcare practice, they are an absolute requirement of any dental practice that functions as or within a FQHC.  Formal policies and quality assurance tools that contribute to and document dental care quality are important.  A successful program will also document the quality of the experience of the program through patient and staff surveys.  We also ensure that the dental program is formally included in the overall health center’s quality initiatives.

Finally, a successful dental program will comply with all applicable GOVERNANCE rules and regulations.  In order to continue to provide access to quality oral health care, the program’s financial planning, outcomes and quality metrics must meet FQHC governance mandates.

So, we have found that FQHC dental program success is achieved by carefully balancing mission, strategy and planning in the dimensions of access, finance, outcomes, quality and governance.  We set dental program goals that are based on established benchmarks and milestones, by such resources such as the National Network for Oral Health Access, the National Association of Community Health Centers, the Safety Net Dental Clinic Manual and D4 Practice Solutions.

Ultimately, the goals we set ensure that we meet the needs of our patients, that we operate in a financially responsible manner, document the quality of the care we provide and that everything we do complies with the requirements set for us by key stakeholders at the federal, state and local levels.

Dr. Mark J. Doherty
Executive Director, D4 Practice Solutions
Senior Advisor, D4