194 - Improve Access to Dental Care for Patients with Special Health Care Needs Between 16 to 20 years old: A Quality Improvement Project.

Purpose: The purpose of this quality improvement (QI) project is to address barriers to dental care for patients with special health care needs (SHCN) between the ages of 16 to 20 years through the implementation of a referral road map. 

Methods: The research design follows the Institute for Healthcare Improvement (IHI) QI methodology. A referral road map was created to guide pediatric dental residents in referring patients of Children’s Dental Clinic at San Ysidro Health – El Cajon to adult dental homes. A report was generated through the electronic health record, Epic, to track dispensed referrals from June 1 to December 1, 2024, for patients aged 16–20. The data was analyzed using pre- and post-intervention control charts. 

Results: The control charts indicate that the process is in statistical control. The pre-intervention control chart had an upper control limit (UCL) of 2.136 and lower control limit (LCL) of -1.136, while the post-intervention control chart had an UCL of 4.151 and LCL of -2.684. The average number of weekly referrals increased by 46% in the post-intervention phase. This suggests that the referral roadmap was effective in improving access to dental care for patients with SHCN. 

Conclusions: The implementation of the referral roadmap at the Children’s Dental Clinic at San Ysidro Health – El Cajon increased the number of dispensed referrals, helping patients with SHCN transition to adult dental homes at age 16. Future efforts should include another PDSA cycle to identify other interventions on how to increase the number of weekly referrals.


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