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‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance

OBJECTIVE: To investigate which organisational characteristics of primary care dental practices influence the implementation of evidence-based guidance. DESIGN: A multimethod study set within primary care dentistry in Scotland comprising: (1) Semistructured interviews with dental teams to inform dev...

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Autores principales: Cassie, Heather, Treweek, Shaun, McKee, Lorna, Ramsay, Craig, Young, Linda, Clarkson, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352983/
https://www.ncbi.nlm.nih.gov/pubmed/35922111
http://dx.doi.org/10.1136/bmjopen-2021-059564
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author Cassie, Heather
Treweek, Shaun
McKee, Lorna
Ramsay, Craig
Young, Linda
Clarkson, Jan
author_facet Cassie, Heather
Treweek, Shaun
McKee, Lorna
Ramsay, Craig
Young, Linda
Clarkson, Jan
author_sort Cassie, Heather
collection PubMed
description OBJECTIVE: To investigate which organisational characteristics of primary care dental practices influence the implementation of evidence-based guidance. DESIGN: A multimethod study set within primary care dentistry in Scotland comprising: (1) Semistructured interviews with dental teams to inform development of a self-report questionnaire exploring the translation of guidance in primary care dentistry and (2) A questionnaire-based survey and case studies exploring which organisational characteristics influence knowledge translation. RESULTS: Interview data identified three themes: leadership, communication and context. Survey data revealed compliance with recommendations from three topics of dental guidance to be variable, with only 41% (emergency dental care), 19% (oral health assessment and review) and 4% (drug prescribing) of respondents reporting full compliance. Analysis revealed no significant relationship between practice characteristics and compliance with emergency dental care or drug prescribing recommendations. Positive associations were observed between compliance with oral health assessment and review recommendations and having a practice manager, as well as with the type of treatment offered, with fully private practices more likely, and fully National Health Service practices less likely to comply, when compared with those offering a mixture of treatment. Synthesis of the data identified leadership and context as key drivers of guidance uptake. CONCLUSIONS: Evidence-based dental recommendations are not routinely translated into practice, with variable leadership and differing practice contexts being central to poor uptake. Guidelines should aim to tailor recommendations and implementation strategies to reflect the complexities and varying contexts that exist in primary care dentistry, thus facilitating the implementation of evidence-based guidance.
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spelling pubmed-93529832022-08-19 ‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance Cassie, Heather Treweek, Shaun McKee, Lorna Ramsay, Craig Young, Linda Clarkson, Jan BMJ Open Dentistry and Oral Medicine OBJECTIVE: To investigate which organisational characteristics of primary care dental practices influence the implementation of evidence-based guidance. DESIGN: A multimethod study set within primary care dentistry in Scotland comprising: (1) Semistructured interviews with dental teams to inform development of a self-report questionnaire exploring the translation of guidance in primary care dentistry and (2) A questionnaire-based survey and case studies exploring which organisational characteristics influence knowledge translation. RESULTS: Interview data identified three themes: leadership, communication and context. Survey data revealed compliance with recommendations from three topics of dental guidance to be variable, with only 41% (emergency dental care), 19% (oral health assessment and review) and 4% (drug prescribing) of respondents reporting full compliance. Analysis revealed no significant relationship between practice characteristics and compliance with emergency dental care or drug prescribing recommendations. Positive associations were observed between compliance with oral health assessment and review recommendations and having a practice manager, as well as with the type of treatment offered, with fully private practices more likely, and fully National Health Service practices less likely to comply, when compared with those offering a mixture of treatment. Synthesis of the data identified leadership and context as key drivers of guidance uptake. CONCLUSIONS: Evidence-based dental recommendations are not routinely translated into practice, with variable leadership and differing practice contexts being central to poor uptake. Guidelines should aim to tailor recommendations and implementation strategies to reflect the complexities and varying contexts that exist in primary care dentistry, thus facilitating the implementation of evidence-based guidance. BMJ Publishing Group 2022-08-03 /pmc/articles/PMC9352983/ /pubmed/35922111 http://dx.doi.org/10.1136/bmjopen-2021-059564 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Dentistry and Oral Medicine
Cassie, Heather
Treweek, Shaun
McKee, Lorna
Ramsay, Craig
Young, Linda
Clarkson, Jan
‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
title ‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
title_full ‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
title_fullStr ‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
title_full_unstemmed ‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
title_short ‘Well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
title_sort ‘well, in dentistry the dentist is always the boss’: a multi-method exploration of which organisational characteristics of dental practices most influence the implementation of evidence-based guidance
topic Dentistry and Oral Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352983/
https://www.ncbi.nlm.nih.gov/pubmed/35922111
http://dx.doi.org/10.1136/bmjopen-2021-059564
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