# Quality Improvement in General Dental Practice: Situational Analysis for the United Kingdom and Germany

## TL;DR

This study explores how dental professionals in the UK and Germany perceive and implement quality improvement in their practices.

## Contribution

It is the first in a series to analyze QI in European dental care, offering insights into professionals' perceptions and contextual factors.

## Key findings

- Participants described six competing positions on QI, including views on its value and role in dental practice.
- Findings highlight contextual barriers and facilitators to implementing quality improvement in dental settings.
- The study emphasizes the importance of understanding social and situational factors influencing QI activities.

## Abstract

Quality improvement (QI) is important in ensuring standards in oral health care. Despite the growing literature on quality indicators, audit, and feedback, the perceptions and expectations of oral health professionals toward QI remain unclear. Understanding these perspectives, barriers, and facilitators is important to effectively encourage and maintain QI activities in dental practices. This is the first of 6 publications in a series titled “Situational Analysis of QI in Oral Health Care in Europe.”

This study aimed to investigate how QI was conducted and perceived in dental practices in the United Kingdom and Germany.

A situational analysis, comprising desk research and semistructured interviews, was conducted. Data collection was conducted from May to October 2023. Purposive and snowball sampling techniques were used to recruit dental practice participants in the United Kingdom and Germany. Interviews and key texts were thematically analyzed to synthesize 3 maps: a situational map, a social world map, and a positional map.

Eighteen participants were interviewed, comprising dentists, dental hygienists, dental therapists, dental nurses, and practice managers. The participants described 6 competing positions surrounding QI: QI activities were expressed as being worthwhile or box-ticking exercises to satisfy regulators. Some felt that QI detracted from service delivery and should not be the role of the dentist, whereas others stressed the need for a whole-team approach. Some felt that patients were important to judge quality, whereas others felt quality in dentistry required understanding of technical processes beyond the reach of patients.

This study provided insights into how QI activities were carried out in dental practices in the United Kingdom and Germany and how it is was perceived by those working in this environment. This study offers key observations into the situations, social worlds and arenas, and positions that influence QI in dental practices.

The findings from this study highlight several contextual barriers and facilitators to quality improvement in general dental practice. Understanding these determinants of quality improvement is relevant for oral health teams and dental practice managers who aim to develop and implement quality improvement strategies in dental practice.