Applied scope of practice of oral health therapists, dental hygienists and dental therapists

Accepted manuscript online: 14 OCT 2015BACKGROUND: Oral health therapists (OHTs) are an emerging workforce whose training incorporates the skills of dental hygienists (DHs) and dental therapists (DTs). There are concerns that OHTs are underutilised. This study compares the employment characteristics and applied practice scope of OHTs with those of DTs and DHs. METHODS: Members of two professional associations representing DHs, DTs and OHTs, were surveyed by mail. Data collected included demographic and employment characteristics and clinical activity on a typical practice day. Applied practice scope was described by calculating the proportion of practitioners that had provided ≥1 of a selected range of key services. Log binomial regression was used to compare OHTs to DTs and DHs. RESULTS: Response rate was 60.6% (n= 1,083) and of these 90.9% were employed. Preventive services dominated service provision. The proportion of OHTs that provided fluoride applications (77%) was higher than the proportion of DTs (53%, p0.05). CONCLUSION: Overall the applied practice scope of OHTs appeared to differ from DTs and DHs.DN Teusner, N Amarasena, J Satur, S Chrisopoulos and DS Brenna

Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

<p>Abstract</p> <p>Background</p> <p>Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care.</p> <p>Method</p> <p>All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735). Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication.</p> <p>Results</p> <p>Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care.</p> <p>Conclusions</p> <p>While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.</p

A European union and Canadian review of public health nursing preparation and practice.

This study explores the preparation and role of the public health nurse (PHN) across European Union (EU) countries (Finland, Sweden, and the United Kingdom) and Canadian provinces (Alberta, New Brunswick, and Prince Edward Island)

Process redesign for time-based emergency admission targets

Purpose: Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach: A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010. Non-probability sampling identified interview subjects who, through their participation in the redesign initiative, had a detailed understanding of the implementation and outcomes of the initiative. Between April 2012 and January 2013 26 in-depth semi-structured interviews were conducted and analysed with thematic content analysis. Findings: There were four important findings. First, when asked to comment on the impact of the LSS implementation, without prompting the staff spoke of quality of care. Second, there was little agreement among the participants as to whether the project had been successful. Third, despite the recognition of the need for a coordinated effort across the hospital to improve ED access, the redesign process was not successful in reducing existing divides among clinicians and among managers and clinicians. Finally, staff expressed tension between production processes to move patients more quickly and their duty of care to their patients as individuals. Originality/value: One of the first studies to explore the impact of process redesign through in-depth interviews with participating staff, this study adds further evidence that organisation implementing process redesign must ensure the supporting management practices are in place

East Asian Welfare States in Transition

Summaries After the spectacular economic crisis of late 1997, there has been a call for social welfare reform as well as economic restructuring in East Asia. Covering Japan, South Korea and Taiwan, this article first seeks to identify the strengths and weaknesses of the East Asian welfare states. Second, it examines the pressures for reform of the welfare systems. Finally, it addresses the question of whether the low spending East Asian welfare regimes will be maintained in the future. The strength.of the East Asian welfare states mainly lies in their promotion of an ideology of developmentalism and their relatively low cost; while their weakness is that they tend to reinforce socio?economic inequalities. Economic recession and socio?economic pressures as well as inefficiencies within the welfare states create pressure for change. The governments in Japan, South Korea and Taiwan have responded with reform measures appropriate to these nations' social and political context. Despite different policy responses, the welfare states in these countries will become more expensive, although they will remain low spenders among the developed nations