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Patient flows in the care process of mandibular third molar surgery

Lieholm, R; Henricsson, V; Lysell, L; Norlund, A; Rohlin, M; Rosenquist, Bo LU and Knutsson, K (2005) In Swedish Dental Journal 29(3). p.97-104
Abstract
Our aim was to describe patient flows in mandibular third molar surgery at ora I and maxillofacial specialist units. Our hypothesis was that there are variations in how care is delivered and that the variations could be explained by inter-individual variations in surgeons' practice,the quality of the radiographs appended to the referral, and the staffing of the specialist units. A flow chart was constructed to simulate all possible patient flows in the care process. The chart begins with treatment planning, which was drawn up based on documents from the referring dentist or another caregiver; continues with the care process at the oral and maxillofacial surgery unit, including surgical consultations and radiological examinations; and ends... (More)
Our aim was to describe patient flows in mandibular third molar surgery at ora I and maxillofacial specialist units. Our hypothesis was that there are variations in how care is delivered and that the variations could be explained by inter-individual variations in surgeons' practice,the quality of the radiographs appended to the referral, and the staffing of the specialist units. A flow chart was constructed to simulate all possible patient flows in the care process. The chart begins with treatment planning, which was drawn up based on documents from the referring dentist or another caregiver; continues with the care process at the oral and maxillofacial surgery unit, including surgical consultations and radiological examinations; and ends with surgery. Surgeons at four oral and maxillofacial surgery units in the National Health Service in southern Sweden participated. The intention was to collect data on at least 100 patients who had undergone mandibular third molar surgery at each unit. Data on 361 patients were collected. The radiographs appended to the referral were judged to be inappropriate for the majority of the patients (61%). For 13% of these patients, supplementary radiographic examinations were made at the radiology clinic included in the unit,whilst 48% were examined at the oral and maxillofacial surgery clinic. There were eight different patient flow patterns. In one unit with three surgeons, eight different flow patterns were recorded, indicating an interindividual variation among the surgeons. In a second unit, six different flow patterns were recorded. In the last two units, the patient flows appeared to be the same at each unit, although the predominant patient flows in these two units differed. The number of patient visits to the specialist units ranged between one and three. In three specialist units, most patients were called twice whilst in one specialist unit most patients were called only once, to have the third molar removed. Differences existed in the care process. Overall, the number of patient visits seemed not to depend on whether the preoperative radiographic examination was judged to be appropriate or whether the additional radiographs were made at the radiology clinic. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
patient care management, care process, flow chart, radiology, third, molar
in
Swedish Dental Journal
volume
29
issue
3
pages
97 - 104
publisher
Sveriges Tandläkarförbund
external identifiers
  • pmid:16255353
  • wos:000232770500002
  • scopus:26844522083
ISSN
0347-9994
language
English
LU publication?
yes
id
27ef9975-11a8-4507-bd6d-fc0c32831ebc (old id 214394)
alternative location
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=16255353&dopt=Citation
date added to LUP
2007-08-22 12:26:51
date last changed
2017-01-01 07:12:02
@article{27ef9975-11a8-4507-bd6d-fc0c32831ebc,
  abstract     = {Our aim was to describe patient flows in mandibular third molar surgery at ora I and maxillofacial specialist units. Our hypothesis was that there are variations in how care is delivered and that the variations could be explained by inter-individual variations in surgeons' practice,the quality of the radiographs appended to the referral, and the staffing of the specialist units. A flow chart was constructed to simulate all possible patient flows in the care process. The chart begins with treatment planning, which was drawn up based on documents from the referring dentist or another caregiver; continues with the care process at the oral and maxillofacial surgery unit, including surgical consultations and radiological examinations; and ends with surgery. Surgeons at four oral and maxillofacial surgery units in the National Health Service in southern Sweden participated. The intention was to collect data on at least 100 patients who had undergone mandibular third molar surgery at each unit. Data on 361 patients were collected. The radiographs appended to the referral were judged to be inappropriate for the majority of the patients (61%). For 13% of these patients, supplementary radiographic examinations were made at the radiology clinic included in the unit,whilst 48% were examined at the oral and maxillofacial surgery clinic. There were eight different patient flow patterns. In one unit with three surgeons, eight different flow patterns were recorded, indicating an interindividual variation among the surgeons. In a second unit, six different flow patterns were recorded. In the last two units, the patient flows appeared to be the same at each unit, although the predominant patient flows in these two units differed. The number of patient visits to the specialist units ranged between one and three. In three specialist units, most patients were called twice whilst in one specialist unit most patients were called only once, to have the third molar removed. Differences existed in the care process. Overall, the number of patient visits seemed not to depend on whether the preoperative radiographic examination was judged to be appropriate or whether the additional radiographs were made at the radiology clinic.},
  author       = {Lieholm, R and Henricsson, V and Lysell, L and Norlund, A and Rohlin, M and Rosenquist, Bo and Knutsson, K},
  issn         = {0347-9994},
  keyword      = {patient care management,care process,flow chart,radiology,third,molar},
  language     = {eng},
  number       = {3},
  pages        = {97--104},
  publisher    = {Sveriges Tandläkarförbund},
  series       = {Swedish Dental Journal},
  title        = {Patient flows in the care process of mandibular third molar surgery},
  volume       = {29},
  year         = {2005},
}