gms | German Medical Science

Background: Quality assessment and quality improvement are important factors in assuring standards in (oral) health care. Despite the growing literature around audit, feedback and quality indicators the perceptions and expectations of oral health professionals towards quality improvement remain unclear. Understanding these approaches, their barriers and facilitators is important to effectively stimulate and maintain quality improvement activities in dental practices.

Objective: This study aimed to investigate how quality improvement is conducted and perceived in dental practices in the UK and Germany.

Methods: A Situational Analysis method, comprising desk research and semi-structured interviews was conducted in the UK and Germany. Data collection was conducted from June 2023 to October 2023. Purposive and snowball sampling techniques were used for participant recruitment. Interviews and key texts were thematically analysed to synthesise three maps: a situational map, a social world map, and a positional map.

Results: 18 participants, 11 from the UK and 7 from Germany, were included in this study, comprising dentists, dental hygienists, dental therapists, dental nurses, and practice managers. The participants described 6 competing positions surrounding QI: QI activities were expressed as being worthwhile and important or box-ticking exercises to satisfy regulators. Some felt that QI detracted from service delivery and should not be the role of the dentist, whereas others stressed the need for a whole team approach. Some felt that patients were important to judge quality, whereas others felt quality in dentistry required understanding of technical processes outside of the reach of patients.

Implication for research and/or (healthcare) practice: This study provides insights into how quality improvement activities are carried out in dental practices, and how it is perceived by the dental team. This study offers key observations into the situations, social worlds and arenas, and positions that influence quality improvement in primary oral health care. The findings highlight several contextual barriers and facilitators to quality improvement in general dental practice. Understanding these determinants of quality improvement is relevant for dental teams, dental practice managers, researchers as well as policy makers who aim to develop and implement quality improvement strategies in dental practice.

Funding: Other funding; Project name: Horizon Europe DELIVER project; Grant number: 101057077