Bulletin of Dental Education

Considering Chairside Primary Care in the Dental Clinic? There's a Guide for That

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Nursing Guide CoverIt’s been over two years since faculty at Harvard School of Dental Medicine (HSDM) and Northeastern University School of Nursing announced their intention to develop a novel interprofessional model of education and practice. The result: the Nurse Practitioner & Dentist Model for Primary Care (NPD Model). This exciting innovation integrates the delivery of chairside, nurse-led primary care preventive services with the dental visit while educating nurse practitioner (NP) and dental students on working together as a team. 

The project, funded by a three-year cooperative agreement from the Department of Health and Human Services, Health Resources and Services Administration, is in its final grant year, and the investigators are ready to share their experiences. The publication Nurse Practitioner & Dentist Model for Primary Care: A Guide for Implementing Collaborative Care in U.S. Dental Schools outlines the creation and implementation of the NPD Model, which was initiated in the Harvard Dental Center Teaching Practices.

Project leader Maria C. Dolce, Ph.D., RN, CNE, FACHE, explains that the NPD Model puts patients “front and center“ by addressing chronic conditions along with oral health needs. In this way, those most in need of care receive better services. Dissemination of the guide is intended to promote the integration of person-centered primary care into dental education experiences beyond Harvard. Dr. Dolce, who is now an Associate Professor at the Stony Brook School of Nursing, says faculty at other dental schools who are considering initiating a similar program are already putting the publication to use.

The guide describes the model, its successes and the lessons learned during implementation to assist others who may want to follow the same path. While not intended as an exhaustive step-by-step manual, the guide provides detailed information about how program leaders at HSDM tackled major elements of planning and execution. Topics covered include how to:

  • Recruit program champions who will support the initiative.
  • Partner with local nursing education programs.
  • Determine what faculty, staff and resources are needed.
  • Adapt the dental school curriculum to integrate lessons in collaborative practice.
  • Modify the practice environment to accommodate primary care activities.
  • Monitor and evaluate student progress and patient outcomes.
  • Sustain the program by introducing medical billing.

The guide contains examples that illustrate how implementation looked at HSDM and includes feedback from faculty and students who participated in the program. Most notably, participating NP and dental students say they now recognize the importance of the oral exam for a patient’s long-term overall health, and they are impressed by the increased level of care received by patients who were able to improve self-management of their chronic condition(s). 

Student feedback like this is music to the ears of program originators, such as the Dean of HSDM, R. Bruce Donoff, D.M.D., M.D. Dr. Donoff says that one aim of implementing the NPD Model was “to help move the integration of dentistry and medicine ever closer to the forefront of education, research and patient care.” Students who have learned to value integrated care will further this aim by taking what they’ve learned to their future practice.

The Nurse Practitioner & Dentist Model for Primary Care: A Guide for Implementing Collaborative Care in U.S. Dental Schools is available on the HSDM website. Be sure to stay tuned, because there’s more to come. The project leaders included a research element in the programming and have collected data on student learning and patient outcomes. They expect to publish their findings within the year. In the meantime, ADEA will host a webinar at noon on May 1, during which NPD participants will answer questions about the model and their experience implementing it at HSDM.

This project was funded by the United States Department of Health and Human Services, Health Resources and Services Administration, through the Nurse Education, Practice, Quality, and Retention Program for Interprofessional Collaborative Practice (Grant #UD7HP28534).  

Courtesy of Debra Werrlein

Published on March 14, 2018

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