# Patient Reported Outcome Measures and Patient Reported Experience Measures for Dental Practice Quality Improvement Via Deliberative Stakeholder Consultation in the United Kingdom

## TL;DR

This study identifies key patient feedback measures to improve dental care quality in the UK through stakeholder consultation.

## Contribution

The study is the first to identify actionable PROMs and PREMs for audit and feedback in dental practices.

## Key findings

- Eleven measures were selected for dental encounters to support quality improvement.
- Communication and pain management were top priorities across different dental visits.
- Stakeholder consultations proved effective for prioritizing patient feedback measures.

## Abstract

Patient feedback have potential to drive quality improvement in dental care. However, there is a lack of clarity regarding which elements of patient feedback should be used. This study aimed to select appropriate patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for use in audit and feedback-based quality improvement in dental practices in the UK.

A 2-phase, evidence-informed deliberative process—comprising evidence synthesis and Deliberative Stakeholder Consultations (DSCs)—was conducted. Phase 1: PROMs and PREMs candidate items were identified through systematic literature search and thematically analyzed. Phase 2: Dental patients and professionals were recruited for DSCs through purposive and snowball sampling. Inductive thematic analysis of DSC transcripts was conducted, and the final measures were agreed (5 for each dental encounter: check-up, planned treatment, and urgent care).

In phase 1, 672 measures (across 8 themes such as psychological/social impacts) were identified. In phase 2, 8 dentists and 5 patients participated (March-May 2024). Stakeholder priorities were as follows. Check-up appointments: dentist’s communication skills regarding treatment options and cost, and the cleanliness of facilities. Planned treatment: effective pain management during procedures and overall satisfaction with treatment. Urgent care: management of patient fear/anxiety and pain relief following a procedure. Communication of treatment progress and provision of post-operative advice were considered important in both planned and routine treatment. Waiting times for appointments were a priority across all encounters.

Eleven measures (after removing duplicates) were selected for the encounters to offer meaningful potential for operationalizing quality improvement in dental practices. DSCs were also perceived as a useful method for prioritizing measures for quality improvement.

This study is the first to identify actionable PROMs and PREMs which can be used for audit and feedback loops in dental practices. These measures will be tested in DELIVER case studies.