JO'K OSAP 2012
19
OSAP SYMPOSIUM 2012 DR. JOHN O’KEEFE OTTAWA, CANADA Infection Prevention and Control (IPAC) Compliance in Dentistry - a Canadian Perspective
-
Upload
seanocaoimh -
Category
Documents
-
view
263 -
download
0
Transcript of JO'K OSAP 2012
OSAP SYMPOSIUM 2012DR. JOHN O’KEEFEOTTAWA, CANADA
Infection Prevention and Control (IPAC) Compliance in Dentistry - a Canadian Perspective
Objectives & Content
How is dentistry practiced & regulated in Canada?
How is IPAC regulated in Canada?
How is IPAC compliance encouraged in Canada?
Dental Practice in Canada
Big country with small population
Powers highly devolved to 10 provinces & 3 territories
Single government payer for most MD & hospital-based “medically necessary” services
95% of dental spending is in private sector
Dentistry is a $13 billion sector (7% of total health spending)
Dental Practice in Canada (cont’d)
Most offices are solo or small # of dentists
Trend towards more “organization”
10 dental schools, 41 hygiene schools, 42 assisting schools (Accredited)
Approximately 20,000 dentists, 24,000 hygienists, & 28,000 assistants
Feminization is an important trend
Organization of the sector is evolving
Regulation of dentistry in Canada (Professional)
Transition to greater accountability over 30 year period
A provincial & territorial responsibility
Dentistry, hygiene & assisting regulation - separated to greater or lesser degree
Professional majorities on Boards that are “autonomous” to greater or lesser degree
However, government powers loom large and are looming larger
Regulation of Dentistry in Canada
(Workplace Health & Safety)
Mainly Provincial/ Territorial for everyday practice
Public health agencies more prominent now
Canadian Standards Association
WHMIS, PIDAC, Departments of Labour, Workers’ Insurance Boards, provincial equivalents of OHSA
Regulation of IPAC in Canada
Systems are in transition
Historical reasons for developments similar to those in the US
Dental regulators now “own” the issue
For this presentation I consulted with 8 Dental Regulatory Authorities (DRAs)
This presentation will present highlights & not compare jurisdictions in matters of detail
Alberta is a notable case – “Vegreville Factor”
Regulation of IPAC in Canada (cont’d)
DRAs currently play primary role
Public health agencies becoming more involved
Regulators of other oral health care workers may have important roles
Regulation of IPAC in Canada (cont’d)
Range of stages of development of guidelines with more or less government “interest”
Education is big part of strategy
Public pressure currently seems low – but “Vegreville Factor” is on radar screens
DRAs want to be proactive & balanced
Subjects that get debated
Single-use instruments
Frequency of monitoring with biological indicators
Cost-benefit questions
“Where’s the evidence?”
Are dental offices like hospital ORs?
Mandatory reporting to public health agencies
Compliance measurement & encouragement
Structures & processes are in place
No formal outcomes research published since 1999 (McCarthy et al – survey in 1995)
“All seems rosy in the garden at present”
But you never know…………Vegreville?
Compliance encouragement
Guidelines but not standards in most places
Range from audit through to complaint-driven, but trend is towards audit
Education component is strong – leading to culture change
People need tools to facilitate change
Staff knowledge of processes and “corrective actions” are key to change
Encouraging compliance?
By force?
Encouraging Compliance?
Given the nature of dental offices:
Compliance encouragement is a balancing act
Things are not black & white
Compliance encouragement (as I see it)
Understand human nature and mould strategies accordingly
Understand barriers and drivers of change
Realistic appraisal of how we compare with other health care sectors
Politics is art of the possible
DRAs take their role very seriously
The major challenge (as I see it)
Responsible regulation of our sector to maintain public confidence in safety and efficacy of oral health care in Canada
My sincere thanks to:
Dr. David Tobias, Dr. Peter Stevenson-Moore,
Dr. Darryl Schultz, Dr. Gordon Thompson,
Dr. Bernie White, Dr. Marcel Van Woensel,
Dr. Mike Gardiner, Dr. Ray Wenn,
Dr. Bill MacInnis, Dr. Kent Orlando,
Mr. Irwin Fefergrad
The End
Discussion Time
