Clinical Practice

  • Nurse taking blood pressure

    Clinical Models that Integrate Medical and Dental Care

We pilot new models to develop best practices for clinics of the future.

COLLABORATORS IN PRACTICE
Partnerships with health systems and communities to better integrate oral health with primary care services.

We are working with community-based organizations to develop best practices for the integration of dental services for medically complex patients. Together we are learning how to most effectively deliver oral health care to these vulnerable populations and we are studying the associated health and cost outcomes. Our partners are based throughout New England and across the country.

PHASE I: NURSE PRACTITIONER-DENTIST MODEL (NPD)
Innovative model where a Nurse Practitoner works in the dental clinic.

Piloted since 2015 at the Harvard School of Dental Medicine’s Teaching Clinic, Phase I of the NPD model is a collaboration with Northeastern University made possible with funding from HRSA. The model promotes interprofessional practice and education by integrating primary care services provided by a nurse practitioner into an academic dental practice environment.

Nursing and dental students work in teams and are jointly responsible for providing primary care and dental services to patients, who may be screened for hypertension and diabetes in their dental visit.

During supervised clinical rotations, dental and medical students learn how each profession formulates diagnoses, implements preventive interventions, and makes referrals within their scopes of practice. Students develop interprofessional plans of care under the direct supervision of NP and dental faculty. Since February 2016 dozens of NP students from Northeastern University have rotated through the dental clinic and have enhanced their oral health skills.

Project team releases guide and webinar to promote adoption of NPD model

NPD Collaborative Care Guide bookTo encourage educational institutions and private practices to adopt the NPD model, the team released a guide and webinar that provide a framework for planning, implementing, and evaluating the NPD collaborative care model. The guide includes templates for developing timelines, estimating resource requirements, determining quality measures, designing curriculum, and planning operational workflows.

The guide and webinar are available online at no cost:
A Guide for Implementing Collaborative Care in U.S. Dental Schools (PDF) and 
Webinar

ANNOUNCING PHASE II: NURSE PRACTITIONER-DENTIST MODEL (NPD)

Phase II of the NPD program is now underway, thanks to the collaboration between Harvard School of Dental Medicine (HSDM) and Tufts University School of Dental Medicine. This new funding from CareQuest, enables us to continue administering person-centered primary and preventive care, fostering improved patient outcomes and broader access to healthcare services.

In the Nurse Practitioner-Dentist (NPD) model, nurse practitioners take on a vital role in providing comprehensive healthcare services to our patients. From physical exams to annual wellness checks and counseling on nutrition and tobacco cessation, our mission is to deliver holistic care that makes a real difference in people's lives, and to better integrate oral health with primary care services.

A Guide for Implementing Collaborative Care in U.S. Dental Schools (PDF) is available and will be updated in the new year (2024)

Stay tuned for updates on our progress as we continue to make strides in advancing healthcare practices! 

NATIONAL CENTER FOR EQUITABLE CARE FOR ELDERS (NCECE)
The National Center for Equitable Care for Elders aims to improve health care access and outcomes for vulnerable older adult populations by providing training for heath care providers who serve older adult patients, particularly in underserved areas. Examples include webinars that teach strategies for delivering care to patients with dementia, disabilities, depression, or a chronic health condition. The need is enormous—in 2010 there were 40.3 million people aged 65 and above (13% of overall population). At the same time, the number of physicians with advanced geriatrics training is declining and many are opting out of Medicare. 

TEAMING AND INTEGRATING for SMILES and HEALTH (TISH)

The Teaming and Integrating for Smiles and Health (TISH) Learning Collaborative operated to help healthcare organizations accelerate progress in integrating oral and primary care delivery. By providing expert support and a structure for testing change, the project aimed to improve the early detection of hypertension in the dental setting and of gingivitis in the primary care setting and to increase the rate of bi-directional referrals between oral and primary care partners.