A. Introduction

The effects of oral disease on overall health are alarming. Oral disease has an impact on physical, psychological, social, and economic health and well-being, often resulting in pain, diminished function, and reduced quality of life. Furthermore, poor oral health is associated with increased bacterial systemic exposure and increased inflammatory factors that can lead to adverse health outcomes such as uncontrolled diabetes, cardiovascular disease, and respiratory disease.

The shift in focus on improving the provision of care in the ambulatory care settings due to the numerous advantages such as; reduction in health care related costs, reduction in length of stay at hospitals as well as promoting health through health education and prevention, thus emphasizing the health care on the people themselves and their own capacity to maintain health. The ambulatory care standards would provide aid in identification, guidance and improvement of areas that would lead if implemented in the ambulatory care settings to increasing patient safety in a systematic and strategic manner. Under the umbrella of ambulatory care undergoes the dental care and its services. The dental standards would also contribute the promotion quality and safety of dental services provided in relevant settings.

B. Aim

The standards identify those aspects that the HCAC regards as essential to achieve the intended goals. They specify the optimal requirements to ensure quality services related to patient management including patient care and the outcomes of the care, patient satisfaction, and patient safety. It also serves as an education guide for dental facilities that wish to establish new systems or improve existing ones.

C. Framework and guiding principles of HCAC Hospital Standards

The ambulatory care standards were developed in line with the non-inpatient care framework which emphasizes that ambulatory care that takes place as a day attendance at a health care facility has to be provided according to the best practice care to assure safe and sustainable, patient focused care. The non-inpatient care term covers a broad range of care delivery from preventative and primary care, through to specialist services and tertiary level care, and is collectively referred to as non-inpatient care. This Framework does not imply that all these services will be delivered outside of hospitals; some services will and should continue to be delivered in hospitals for reasons of patient safety, quality and efficiency. However many services currently delivered in the hospital settings can be provided safely and effectively in the community setting.

The framework is aligned with the following guiding principles:

• Improved access to services
• Provide safe, high quality evidence based health care
• Promote a patient centered continuum of care
• Optimize public and private services
• Improve the balance of preventative, primary and acute care
• Support a highly skilled and dedicated workforce

What does patient - centered mean?

Patient-centered care is based on several key principles:

Dignity and respect:
Incorporating the values, beliefs and cultural backgrounds of clients into the planning and delivery of care; resolving complaints and conflicts as soon as possible.

Information sharing:
Encouraging clients to share their perspectives & questions and healthcare professionals providing information regarding illness & treatment options in terms that the client can understand.

Participation:
Preparing and supporting clients and families to participate in care at the level they choose.

Continuity:
Providing care across the continuum; designing systems that promote seamless transitions between home, hospital, primary health care, and the community.

D. Eligible Institutions

Facilities that offer dental services are eligible to apply.

E. Organization of the standards Manual

The standards are organized into key functions referred as “clusters”, they are divided into ten clusters as follows:

Cluster 1: Governance and Leadership

Cluster 2: Patient’s Rights

Cluster 3: Access and Continuity of Care

Cluster 4: Patient Care

• Patient assessment
• General Care
• Anesthesia and inhalation sedation care
• Dental Radiography
• Emergency dental care
• Medication care

Cluster 5: Clinical records Management

Cluster 6: Human Resources Management

Cluster 7: Facility and Environment Safety

Cluster 8: Infection Prevention and Control

Cluster 9: Quality Improvement and Patient Safety

Cluster 10: Information Management

For each cluster, there is an intent statement that assists the dental care professionals to understand the standards and a list of the key documents that are required for review by the surveyors. In each cluster, every standard is listed followed by the measurable elements, and survey process. The survey process is identical to what the surveyors will look for to determine how to score the standard.

F. Classification of standards

A number of standards have been identified as essential according to the following criteria:

• central organizational processes;
• processes requiring workforce competencies;
• processes with immediate impact on patient safety and clinical effectiveness;
• address laws and regulations