This evaluation focuses on the second phase of the Primary Care Dentistry Collaborative only. This second phase broadly followed the Breakthrough Series Collaborative methodology within the constraints of the busy VT curriculum. Two care bundles were implemented during this phase of testing: (1) a periodontal care bundle, focusing on the prevention of periodontal disease and (2) a high-risk medication medical histories bundle. During the collaborative, dental teams were asked to implement one of the care bundles and complete a safety climate survey within their practice team. Each participating NHS Board was provided with resources to appoint a clinical lead and a facilitator to support the collaborative. Representatives from each dental team were invited to attend an induction event, as well as two national learning events over the course of the collaborative. In turn, these team members were asked to share learning from these events with the rest of their team. For the VT practices, regular study days were identified for the introduction of QI education and training and to monitor progress. Practice data were submitted monthly and the HIS clinical lead convened a feedback session at the end of the project.

The evaluation comprised a multimethod approach underpinned by the Theoretical Domains Framework (TDF) and the Kirkpatrick model.12 The TDF is derived from a number of behavioural theories and constructs and proposes that determinants of behaviour can be clustered into 14 domains. The TDF has been used extensively to explore and explain variation in clinical practice.13–15 The Kirkpatrick model is a framework that can be used to objectively analyse the effectiveness and impact of training.

Quantitative data were gathered using a baseline and follow-up questionnaire-based survey to team members within participating practices. Qualitative data were gathered using telephone and face-to-face interviews with participating dental team members and HB representatives, as well as practice-based case studies.

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