ASEAN Chief Dental Officers Meeting: Quality of Dental Services in Brunei Darussalam Dr. Sylviana Haji Moris BDS (Dundee); MSc Dental Public Health (Kings College London) Head of Primary Oral Care Services Division Department of Dental Services Brunei Darussalam 27.08.2013
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ASEAN Chief Dental Officers Meeting: Quality of Dental Services in Brunei Darussalam
ASEAN Chief Dental Officers Meeting: Quality of Dental Services in Brunei Darussalam. Dr. Sylviana Haji Moris BDS (Dundee); MSc Dental Public Health (Kings College London) Head of Primary Oral Care Services Division Department of Dental Services Brunei Darussalam. 27.08.2013. - PowerPoint PPT Presentation
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ASEAN Chief Dental Officers Meeting:
Quality of Dental Services in
Brunei Darussalam
Dr. Sylviana Haji MorisBDS (Dundee); MSc Dental Public Health (Kings College London)Head of Primary Oral Care Services DivisionDepartment of Dental ServicesBrunei Darussalam
27.08.2013
Country Profile Vision & Mission Organization structure & Workforce Oral health status Quality of Dental services:
Capital City: Bandar Seri Begawan 4 districts: Brunei Muara (housing the
capital city), Tutong, Belait & Temburong
VISION• Together towards a Healthy Nation
MISSION
• To improve Oral Health through effective, equitable, affordable, accessible, safe & sustainable Oral Health Care in Brunei Darussalam
AIM• Healthy Mouth, Healthy Nation
ORGANIZATION STRUCTURE
81 Dentists52 locals : 29 non-locals
37 Dental Technologists/Technicians
36 locals : 1 non-locals
104 Dental Nurses102 locals : 2 non-locals
88 Dental Assistants
41 Administrative Staff
TOTAL DENTAL WORKFORCE= 352
5 - 6 years old 10 - 12 years old 13 - 15 years old 35 - 44 years old
% caries free
dmft% caries
freeDMFT
% caries free
DMFT% caries
freeDMFT
11.3 7.1 12.9 4.82 5.8 7.24 1.7 14.4
CPITN Score% of 10 –
12 years old% of 13 –
15 years old% of 35 –
44 years old
0 (Healthy periodontium) 1.3 0.7 0
1 (Bleeding on probing) 76.4 75.7 43.4
2 (Presence of calculus) 86.4 87 85.7
3 (Pockets 4 – 5 mm) N/A 5.1 65.4
4 (Pockets 6 mm or more) N/A 0 20.6
National OH Survey 1999
ORAL HEALTH STATUS
PATIENT SAFETY
Health & Safety Division established in 2011– Infection Control Unit– Fire Safety Unit– Radiation Protection Unit– Medical Emergency Unit– Hazardous Waste Disposal Unit– First Aid Unit– Occupational Health Unit
Emergency service (on-call after-office hours) at all major hospitals (A&E department)
Audit done– Waiting time of patients attending Adult Dental
Outpatient Services in National Dental Centre during off-peak & peak periods in June 2012
TIMELINESS
Quality of Dental
services
AVERAGE WAITING TIME BETWEEN TAKING QUEUE NUMBER & REGISTRATION,& BETWEEN REGISTRATIONS & FIRST CALLED BY DENTAL SURGERY ASSISTANT (DSA)
TIM
ELIN
ESS
COMPUTERIZED RECORDS
Bru-HIMS ( Brunei Darussalam Healthcare Information & Management System) launched in Tutong District in 2011
Expected to be fully operational in all 4 districts by 2014
Main objective of BRU-HIMS system
– To help improve quality of medical care Computerized records will help reduce
registration timeTIM
ELIN
ESS
REFERRALS TO SPECIALIST CARE Prompt referral for Emergency cases Waiting list
– Orthodontic Unit: 4 years
– Prosthodontic Unit: 6 months
– Endodontic Unit: 4 months
– Oral Surgery: 3 weeks
– Periodontic: 3 months
– Pedodontic & Restorative (Implants): NilTIM
ELIN
ESS
In 2002, His Majesty the Sultan of Brunei Darussalam urged all Ministries & Departments to produce ‘Work Procedure Manual’ (Standard Operating Procedures) to improve civil service
EFFICIENCY
Quality of Dental
services
Ensure delivery of services is efficiently carried out by having all consumables, instruments & equipment readily available at all time
FINANCE UNITEF
FICI
ENCY
Advice on equipment safety hazards, equipment compatibility & quality of equipment
Preventive maintenance & breakdown repair of dental equipment
Equipment commissioning & acceptance test for new dental equipment
Replace unreliable & obsolete equipment & provide technical report for equipment write-off
BIOMEDICAL ENGINEERING UNIT
EFFI
CIEN
CY
Preventive Maintenance Contract of Dental Chairs & Equipment with Local Dental Supplier
Cost-efficient workforce development strategy– More expensive to train Dentists– Poor recruitment for Bachelor of Dental Surgery
Train dual qualified Dental Hygienists/ Therapists who can provide primary dental care & dental health education to children & adults
Provide ‘top-up’ course to expand scope of work of existing Dental Nurses
DENTAL HYGIENE & THERAPY TRAINING PROGRAM
EFFI
CIEN
CY
Procurement In-Service Training Disciplinary Recruitment Promotion Write-off Welfare
VARIOUS COMMITTEESEF
FICI
ENCY
Primary Oral Care Services– 21 dental clinics throughout the country
Specialist Care Services– Full-time in Brunei-Muara: All – Full-time in Tutong: Orthodontic– Part-time in Tutong: Paedodontic & Oral Surgery– Full-time in Belait: Paedodontic, Oral Surgery,
Orthodontic– Part-time in Belait: Prosthodontic, Endodontic &
Periodontic
EQUITY
Quality of Dental
services
EFFE
CTIV
ENES
S
SAUDHA
BELAIT DISTRICT
Legends:
Dental Clinic in Health Centre (Full-Time)
Hospital-based Dental Clinic
National Dental Centre
TUTONG DISTRICT
TEMBURONG DISTRICT
SSB Hospital (33,067)
Seria HC (13,093)
Sg. Liang HC (12,760)
PMMPHAMB Hospital (33,400)
PIHM Hospital (8,856)
Muara HC (25,462)
RIPAS Hospital
Sg. Assam HC
(20,247)
Sg. Hanching HC (41,117)
Police HC (3,240)
National Dental Centre (60,347)
Sengkurong HC (56,017)
Labi HC (1,426)
Telisai HC (7,068)
Lamunin HC (10,720) Dental Clinic in Health Centre (Part-
Time)
Sungai Besar HC (1,917)
Subok HC (2,732)
Mata-Mata HC (6,699)
Bunut HC (1,709)
Jerudong Prison (240)
Pengkalan Batu HC (13,031)
Rimba HC (63,621)
BRUNEI-MUARA
DISTRICT
PAEDODONTIC UNIT Provide specialised & comprehensive dental care for
children with special needs & medically compromised
Provide preventive programme & oral health education to both children with special needs & their carers
EQU
ITY
SCHEME OF CHARGESOUT-PATIENT – ATTENDANCE FEES Registration Fee :
Challenges to ensure/monitor quality– Insufficient workforce
Dentists play multiple roles– Workforce recruitment & retention– Limited room/facilities for expansion– High burden of oral diseases– High demand for treatment– Lower priority for prevention– Procurement of dental supplies
@ Department of Dental Services, Brunei Darussalam