Moving Towards Clinic: Applying Behavioral Science to GSDM Patients PDF

Moving Towards Clinic: Applying Principles of Behavioral Science to the GSDM Patient Treatment Center Matt Mara DMD, EdD Objectives 1. Apply theories of behavioral science when reviewing a medical history in SALUD and providing patient counseling in the patient treatment center. 2. Generate a list o...

Moving Towards Clinic: Applying Principles of Behavioral Science to the GSDM Patient Treatment Center Matt Mara DMD, EdD Objectives 1. Apply theories of behavioral science when reviewing a medical history in SALUD and providing patient counseling in the patient treatment center. 2. Generate a list of appropriate interprofessional (non-dental healthcare providers) referrals based on a clinical scenario. Elicit First (Written Assignment #1) Counsel Second (Written Assignment #2) Before you can provide proper counseling to your patient you must collect all pertinent information. o Almost always this requires additional questions beyond surface review of a patient's medical history. o Topics include: ▪ Current actions ▪ Desired actions ▪ Past experiences ▪ Motivation Asking questions and collecting information first allows the provider to tailor specific counseling and recommendations. Counseling in the dental office often require collaboration with other healthcare professionals. Intraprofessional Healthcare Teams Involves multiple members of the same profession working collaboratively to deliver patient care. Intraprofessional interactions with Members of the Dental Team Dentist Hygienist Assistants Front Desk Office Manager Interprofessional Healthcare Teams Interprofessional collaboration is defined as healthcare professionals from different professions working together. Primary Care Physician Scope of Practice: Primary care physicians specifically are trained for and skilled in comprehensive, first contact, and continuing care for persons with any undiagnosed sign, symptom, or health concern (the “undifferentiated” patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis. Link to Oral Health: o Medical consults – may be a contact with PCP office o May identify oral health problems in their patients and refer to dentist Link to GSDM Medical History: o #4:Has there been any changes to your health in the last year? o #5: Have you been hospitalized or had a serious illness in the last 3 years? o #6: Are you being treated by a physician now? o #7:Date of last medical exam Nurse Practitioner Scope of Practice: Assess patients, order and interpret diagnostic tests, make diagnoses as well as initiate and manage treatment plans—including prescribing medications. They have advanced clinical training beyond their initial professional RN preparation. Link to Oral Health: o Medical consults – may be a contact with PCP office o May identify oral health problems in their patients and refer to dentist Link to GSDM Medical History: o #4:Has there been any changes to your health in the last year? o #5: Have you been hospitalized or had a serious illness in the last 3 years? o #6: Are you being treated by a physician now? o #7:Date of last medical exam Physician's Assistant (PA) Scope of Practice: Diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. Link to Oral Health: o Provide medical consults o May refer patients to the dental office Link to GSDM Medical History: o #4:Has there been any changes to your health in the last year? o #5: Have you been hospitalized or had a serious illness in the last 3 years? o #6: Are you being treated by a physician now? o #7:Date of last medical exam Occupational Therapist Scope of practice: Help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities. Link to oral health: Oral Hygiene adaption for those with impaired fine motor skills (toothbrushes with larger handles etc.). Link to GSDM Medical History: o #50 During the past 3 months, how often have your experienced the following difficulties because of your teeth or gums?* ▪ Eating certain foods ▪ Avoid going out Physical Therapist Scope of Practice: Diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Link to oral health: TMJ evaluation and treatment Link to GSDM Medical History: o #25 Joint Pain or Stiffness Social Worker Scope of practice: Help people obtain tangible services; provide counseling and psychotherapy with individuals, families, and groups; help communities or groups provide or improve social and health services. Link to oral health: o Determine eligibility for MassHealth, Medicare, and provide referrals to agencies that will assist in the signup process o Assist patients are experiencing difficulties, such as cultural or language differences, unreliable transportation, or lack of food, clothing, and shelter. o Assist a provider with a patient dealing with depression, anxiety, or a substance abuse disorder. o Work with patients to develop a safety plan and provide access to community resources should a provider notice evidence of child abuse or intimate partner violence Link to GSDM Medical History: o #9 Have you had any problems with your prior dental treatment? o #38 Mental illness/psychological conditions (anxiety disorder) o #49 other conditions that may affect dental treatment o #52 In the past three months how often did you feel nervous or selfconscious because of problems with your mouth, teeth, or dentures? Clinical Psychologist Scope of Practice: Provide continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision. Link to oral health: o Referral for anxiety/depression o Prescribe medications that can cause xerostomia – which increases caries risk o In patients which they prescribe xerostomia inducing meds – refer to dentist to increase preventive regimen Link to GSDM Medical History: o #9 Have you had any problems with your prior dental treatment? #38 Mental illness/psychological conditions (anxiety disorder) #52 In the past three months how often did you feel nervous or self-conscious because of problems with your mouth, teeth, or dentures? Registered Dietician Scope of Practice: Food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living. Link to oral health: o Refer individuals with high caries risk o Refer patients who want to make overall dietary changes Link to GSDM Medical History: o #16 Weight loss o #50- Avoid eating specific foods Optometrist Scope of practice: Provides annual or routine eye exams, including eye health education; diagnosis of eye condition; prescriptions for eyeglasses, contact lenses, and other visual aids. Link to oral health: Referral for vision problems which may interfere with ability to perform proper oral hygiene (and interfere with quality of life). Link to GSDM Medical History: o #29 Blurred vision Athletic Trainers Scope of practice: Provide primary care, injury and illness prevention, wellness promotion and education, emergent care, examination and clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions. Link to oral health: o Refer to dentists for avulsed teeth o Promote mouthguards when appropriate Speech & Language Pathologists Scope of Practice: Work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive communication, and swallowing disorders in all ages. Link to oral health: o Oral health problems such as missing teeth can impact the ability to speak o May serve as referrals to the dentist Pharmacist Scope of practice: Distribute prescription drugs to individuals. Provide advice to patients and other health professionals on how to use or take medication, the correct dose of a drug, and potential side effects/interactions. Administer vaccines. Link to oral health: o May identify drug interactions, especially if patients do not disclose all meds on their med history forms o Can educate patient about xerostomia effects and refer to dentist o Can offer alternative medication choices in case of aforementioned issues Link to GSDM Medical History: o #11 current medications o #12 allergies o #34 dry mouth Activity Consider your patient for your written assignments #1 and #2 in this course... o First: Find the link to the Excel Workbook: Class7 Referrals under the course content tab o Second: Select a non-dental provider to refer your patient to based on your written assigned patient's medical history o Third: script out exactly what you would say when explaining/offering the referral to your patient. During the examination of your new 32-year-old patient, Tom, you identify he has 8 teeth with untreated decay. As part of the medical history review, Tom reported that he brushes his teeth 2-3 times a day and flosses every day. There is a moderate amount of plaque on the teeth but no signs of periodontal disease. Think about what additional information you would want to gather from Tom. From what you know, a referral to which of the following health professionals would be the most helpful to Tom if he wants to improve his oral health. a) Nurse Practitioner b) Physical Therapist c) Pharmacist d) Registered Dietician Announcements Discussion Board #4: Due by Thursday May 2nd at 11:59pm Written Final Exam (50 questions) Friday May 3rd 8-9:50am L1101 o Transtheoretical Model of Behavior Change (10 questions) o Motivational Interviewing & Reflective Listening (10 questions) o Case Application (10 questions) o Social cognitive theory, the health belief model, and self-determination theory (5 questions) o Self-efficacy, Locus of Control (internal and external), social support, stress (5 questions) o Application based questions linking behavioral science to ethics and professionalism, treating vulnerable populations, and the patient treatment center. (10 questions) o Please write a short note on the Kudo Board wall for Paul, Muthoni & Dawn/Emmerson.