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Managing Dispersed Outreach: Is it worth it?

Managing Dispersed Outreach: Is it worth it?. Michael Smith. Spectrum of Outreach. The Mount, Hemsworth 25km. Genesis Lynton House. High Green. Fairlawns. Southey Green, Firth Park & Wheata Place. Taptonville House. Dearne Valley DAC. Rotherham. Chesterfield. Sheffield.

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Managing Dispersed Outreach: Is it worth it?

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  1. Managing Dispersed Outreach: Is it worth it? Michael Smith

  2. Spectrum of Outreach

  3. The Mount, Hemsworth 25km Genesis Lynton House High Green Fairlawns Southey Green, Firth Park & Wheata Place Taptonville House Dearne Valley DAC Rotherham Chesterfield Sheffield Salaried Services Dental Practices

  4. Content • Brief Description • Development • Operation

  5. Sheffield’s Outreach Aims • Professional Responsibility • Public Health Dentistry • Practice Environment • Clinical Skills

  6. Work 4+ days a week for 20+ weeks The Outreach Year Introduction to Primary Care TeamTraining Year 2 H&T Outreach Project Audit Project Teamwork Project

  7. Content • Brief Description • Development • Operation

  8. Development • Decision to adopt outreach • Funding HEFCE £0.8M, SHA £1,5M Increased undergraduate intake 3 years to develop a 6 month prog. 2009 38 chairs across 12 locations 64 supervisors + dental nurses

  9. Selection of Practices ~250 dental practices notified▼~24 expressions of interest▼15 costed outline bids▼6 bids selected▼6 delivered

  10. Management Structure Independent Outreach Locations

  11. Quality Management • Shared understanding • Contract • Monitoring of outcomes • Activity • Perception • Training days

  12. Enhancements • Outreach Projectlink two case studies to local health data • Audit Projectdesign, conduct and report an audit • Teamwork Projecthelp develop dental therapy students, assess progress • Visitsother healthcare services, sedation, GPs, domiciliary

  13. Content • Brief Description • Development • Operation

  14. Preparation • Handbook • Lecture ProgrammeIntroduction / Epidemiology Methods / Project work / Quality of Dental Care / Structure of NHS Dentistry / Health Promotion + Managing expectations • Allocations • Meet Hosts

  15. Boundary Crossing… • Students initially nervous • Soon settle • Needlestick injuries Cope et al. J Adv Nursing 2000; 31:850-856Wilcox et al. J Hosp Dent Pract 1977; 11:13-17

  16. Clinical Activity * Lynch & Allen 2007 Br Dent J, Youngson et al. 2007 Br Dent J

  17. Communication • Formal channels • Informal • Time consuming… … but vital Holloway & Dixon, BDJ 1977; 143: 146-150.

  18. Integration • Some staff both Outreach and hospital • Academics present at development days • Students carry (mis)information • Visits by the Dean and L&T Advocate • Annual Review visits

  19. Managing students • Want the practical skills and ‘real’ world • Increase competence • ‘Stand out’ among applicants

  20. Managing - hosts • Altruistic innovators seeking a challenge • Initially uncertain - reassurance • Wide variation between students • Encouraging assessments objective

  21. Managing Recurrent Costs • For: supervision, close dental nursing support, additional materials / wear, time for induction, feedback, coaching, local admin and staff training • £1m pa – paid monthly • BDS travel allowances • H&T Bursary awards • Training events • Office salaries

  22. Summary

  23. Small and dispersed Variation / scattered Admin complex Service ethos ‘Real’ and broad Boundaries to be crossed – Integration more complex Feel ready for VT and practice Single large Standardised Admin eased School’s ethos School-like Smother transitions within course – Easier integration Less familiar with typical practice Is it worth it?

  24. Wider benefits • Partnerships developed • Partners’ reputations’ enhanced inc. outreach staff CVs • Outreach staff want ‘teacher’ training • Students better informed re employment(but then make comparisons) • University logo seen in new communities • Learning kept up-to-date – feedback on currency

  25. Unintended outcomes • Partners flexible and innovative • School increasingly reliant on outreach • Some School staff resistant

  26. Dispersed Outreach: Is it worth it? Yes! No!

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