Clinical Audit of Children's Missed Dental Appointments in a City‐Wide Salaried Community Dental Service in Relation to Guidance on When to Suspect Child Maltreatment. (16th November 2015)

• Record Type: Journal Article
• Authors: Harris, Jennifer C.; Firth, Lauren M.; Chadwick, Barbara L.
• Is Part Of: Child abuse review. Volume 26:Number 3(2017:May/Jun.)
• Page Start: 172
• Page End: 183
• Publication Date: 2015-11-16
• Subjects: missed healthcare appointments -- non‐attendance -- safeguarding children -- neglect -- dental care; Child abuse -- Periodicals; Child abuse -- Great Britain -- Periodicals; Abused children -- Services for -- Periodicals; Abused children -- Services for -- Great Britain -- Periodicals; 362.76
• DOI: 10.1002/car.2419
• Languages: English
• ISSNs: 0952-9136

Abstract

Abstract : Children's missed healthcare appointments may be an alerting feature of neglect so it is essential that concerns are shared with other professionals. The aim of this clinical audit was to investigate the management of missed dental appointments for children in a city‐wide salaried community dental service. Standards for communication with (a) the family, (b) other professionals and (c) child protection referral to social care were developed using NICE Clinical Guidance 89 : When to suspect child maltreatment and the British Society of Paediatric Dentistry's policy document on dental neglect. Information collected from a random sample of 100 clinical records included communication actions within six months of a missed appointment and dental outcome. After reporting the first‐cycle (C1) results, procedures were modified and staff training provided. Sampling and data collection were repeated annually for two further cycles (C2, C3). Communication standards were not fully met in any cycle. The missed appointment rate was 11–12 per cent. An initial small increase in interprofessional communication, including two child protection referrals to social care, was achieved in C2 together with a reduction in unresolved dental outcomes. However, omissions still occurred and improvements were not maintained in the third cycle, demonstrating insufficient consistency to ensure the protection of vulnerable children. 'The aim of this clinical audit was to investigate the management of missed dental appointments for children' Key Practitioner Messages: This paper describes a method of auditing the management of missed dental appointments in relation to maltreatment guidance. We achieved initial small improvements in interprofessional communication and dental outcomes but also identified lapses which might indicate children at risk of neglect who could 'slip through the net'. Dental services, other healthcare services and children's social care must work together to develop better communication pathways. 'Dental services, other healthcare services and children's social care must work together to develop better communication pathways'