Organizational Change in Dental Care

University of Wisconsin (UW)

Status: Completed

Conditions: Patient No Show

Treatments: Behavioral: NIATx model

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT03367416

U56DE027442 (U.S. NIH Grant/Contract)

2017-1247

Details and patient eligibility

About

The proposed research will test the ability of the NIATx Organizational Change Model to improve patient no-show rates as compared to typical training approaches used in dental offices. The purpose of the pilot study is to improve no-show rates and, in the process, test an evidence-based organizational change model that can increase use of evidence-based practices in dental care.

NIATx is not an acronym, it is a proper noun.

Full description

For designing the pilot study, it is assumed that the no-show rates in dental clinics will have similar characteristics and response patterns to previous studies.

The preliminary summary data provided by the participating dental clinics, the current average no-show rate is approximately 20%, which would reduce to 10% using the upper limit of the confidence interval from the preliminary data. Based on a simulation study incorporating the above assumptions, with 5 sites each contributing 160 appointments before and after the intervention, the study will have 84% power to detect the hypothesized effect (OR=0.44) at a two-sided 5% significance level. The probability of observing a decrease in no-show rates in at least 4 out of 5 of the clinics is approximately 90%. We expect over 80 appointments per month in each clinic, so the target number of appointments would be expected to be available in 2-3 months.

For the NIATx Fidelity Scale, if an organization has an average score of 2 or higher on the NIATx Fidelity Scale for 8 of the 13 measures that will be considered significant. In a previous study using a similar process, 73% of the organizations that achieved gains of +10%, had 8 measures or more with an average score of 2 or greater, compared to 40% of those who had gains at <10%.

Enrollment: 43 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

In order to be eligible to participate in this study, staff must be:

• 18 or older
• A paid staff member at a dental clinic participating in the study
• Willing to participate in the interviews and share their ideas and experiences
• Involved in an organizational improvement project at a participating clinic
• Be able and willing to provide verbal consent

Exclusion criteria

An individual who does not regularly interact with patients in a dental clinic.

Trial design

43 participants in 1 patient group

Intervention

Description:

This study will test the NIATx model, an evidence-based behavioral intervention for implementing organizational change and quality improvement in community based health settings with a high proportion of underserved individuals. The goal of the study will be to use the model to identify and implement organizational changes in dental practices that will improve the no-show rate in underserved populations.

Treatment:

Behavioral: NIATx model