Clinical trial NCT03367416: Organizational Change in Dental Care
Official title: Test of an Organizational Change Model in Dental Care Settings
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Patient No Show
Lead sponsor: University of Wisconsin, Madison
Sponsor class: OTHER
Collaborators: name: Medical College of Wisconsin
name: Marquette University
name: National Institute of Dental and Craniofacial Research (NIDCR)
First posted: 2017-12-08
Enrollment: 43
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Community dental clinics that:

* Serve at least a 50 percent minority population
* Accept a high number of Medicaid patients
* Are able to provide de-identified clinic data to the research team
* Are willing to undertake and support an organizational improvement project to decrease no-show rates

Brief summary: 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.

Detailed 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%.

Eligibility criteria: 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.

Primary outcomes:
measure: Analyze clinic data for trends and patterns in patient no-show behaviour.
timeFrame: 7 months
measure: Staff surveys to test clinic adherence to the components of the NIATx model.
timeFrame: 7 months
measure: Patient qualitative interviews to assess the patient experience in missing an appointment.
timeFrame: 2 months
Secondary outcomes:
Other outcomes:
Locations:
city: Madison
country: United States
facility: More Smiles Wisconsin
state: Wisconsin
city: Milwaukee
country: United States
facility: Community Dental Clinic North-Marquette School of Dentistry
state: Wisconsin
city: Milwaukee
country: United States
facility: Community Dental Clinic South-Marquette School of Dentistry
state: Wisconsin
city: Milwaukee
country: United States
facility: Children's Hospital of Wisconsin
state: Wisconsin
Study officials:
affiliation: University of Wisconsin, Madison
name: Todd Molfenter, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Marquette University
name: Christopher Okunseri, BDS
role: PRINCIPAL_INVESTIGATOR
References: