10.59987/ads/2023.1.1-1
Innovative “prescriptions”, to improve the treatment of the citizen in need of odontostomatological care, are published daily on dental journals. These “prescriptions” are mostly indications from The Experts who have the aim of favouring citizens’ access to dental care in the dental facilities of the Servizio Sanitario Nazionale (SSN), which is constantly grappling with the long-standing and never solved problems of waiting lists and staff shortages. Beyond the goodness of the initiative, the arranged action plans always need the commitment of financial resources, nowadays not widely available. The question then arises as to how a project is feasible without the appropriate financial backing or, better yet, how economic resources can be found. However, the reason why the suggestions are never related to structures, technologies and personnel optimization, is not known. One example among many is the appointment agendas of outpatient visits and services, which punctuate the work activity of every health professional, both public and private. Are we sure that the visits' and services' scheduling is calibrated based on actual staff availability and patient demand? A study conducted a few years ago by the WHO Collaborating Centre for Epidemiology and Community Dentistry showed that the average daily time spent using a dental unit in the Public Service is about 3 hours. The time spent on the dental unit turns out to be about half that of a health professionals’ work shift (7.36 hours) established for medical management by the CCNL’s health area (this is not valid for departmental chiefs). The same concept is true for the assistance staff, of the health care professionals, (7.12 hours) working in the dental team. In addition, once the opening time of the dental service is defined, the agendas must be set based on the time space established for each service, which is characterized by a known execution time. This execution time considers not only the average medical time but also some corrections (ancillary times). However, many times this approach is still not used, indeed, in various situations what is seen is an “agenda personalization”. All of this shows that only with the application of simple scheduling rules, accompanied by the system's monitoring and control, we can ensure the delivery of the required services and expand the number of beneficiaries without the need of further monetary expenses for the structure.
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Michele Nardone
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New procedures for the improvement of the SSN for a better access to dental care
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Michele Nardone
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Adda district director;  Head of Corporate Dental Services ASST Melegnano e della Martesana (Mi)
1971-1441
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New procedures for the improvement of the SSN for a better access to dental care
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                                                                             VOLUME 14 NUMERO 1-4 - 2023




                                  A Journal of Odontostomatologic Sciences



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                           DI STOMATOLOGIA
     EDITOR IN CHIEF                               D’Antò Vincenzo                                Di Carlo Gabriele
                                                   University of Naples, Italy                    University of Rome “La Sapienza”, Italy
     Gatto Roberto                                 vincenzo.danto@unina.it                        gabriele.dicarlo@uniroma1.it
     University of L’Aquila, Italy
     roberto.gatto@univaq.it                       Basilicata Michele                             Falisi Giovanni
                                                   University of Tor Vergata Italy                University of L’Aquila, Italy
                                                   michele.basilicata@ptvonline.it                giovanni.falisi@univaq.it
     CONSULTANT EDITORS
                                                   De Angelis Francesca                           Marsili Domenico, Italy
     Allaf Ferdi                                   University of Rome “La Sapienza”, Italy        do.marsili63@gmail.com
     Turkish Aligner Society,Turchia               francesca.deangelis@uniroma1.it
     ferdiallaf@gmail.com                                                                         Nagni Matteo, Italy
                                                   De Nuccio Claudio                              nagnimatteo@hotmail.it
     Caruso Silvia                                 University Cattolica del Sacro Cuore, Italy
     University of L’Aquila, Italy                 cdenuccio@libero.it                            Jamal Sied
     silvia.caruso@univaq.it                                                                      aasayyed@kau.edu.sa
                                                   Yisrael Kornblit
     Docimo Raffaella                              Roly Doctor, Italy                             J.L. Parra Garcia
     University of Tor Vergata , Italy             rolykornblit@gmail.com                         Doctor, Mexico
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                                                   Laganà Giuseppina
     Giancotti Aldo                                University of Tor Vergata , Italy              Pietropaoli Davide
     Department of Clinical Sciences and           giuseppinalagana@libero.it                     University of L’Aquila, Italy
     Translational medicine University Tor                                                        davide.pietropaoli@univaq.it
     Vergata, Italy                                Mohamed R.Islam
     giancotti@uniroma2.it                         University of Dundee, Scotland                 Pistilli Roberto, Italy
                                                   m.r.y.islam@dundeeac.uk                        r_pistilli@libero.it
     Marchetti Enrico
     University of L’Aquila, Italy                 Manzo Paolo                                    Turchetta Nicola, Italy
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Editorial

                             New procedures for the improvement of the SSN for a better access to dental care

                             Innovative “prescriptions”, to improve the treatment of the citizen in need of odontosto-
                             matological care, are published daily on dental journals. These “prescriptions” are mostly
                             indications from The Experts who have the aim of favouring citizens’ access to dental care
                             in the dental facilities of the Servizio Sanitario Nazionale (SSN), which is constantly grap-
                             pling with the long-standing and never solved problems of waiting lists and staff shortages.

                             Beyond the goodness of the initiative, the arranged action plans always need the com-
                             mitment of financial resources, nowadays not widely available. The question then arises
                             as to how a project is feasible without the appropriate financial backing or, better yet, how
                             economic resources can be found.

However, the reason why the suggestions are never related to structures, technologies and personnel optimization, is
not known. One example among many is the appointment agendas of outpatient visits and services, which punctuate
the work activity of every health professional, both public and private.

Are we sure that the visits’ and services’ scheduling is calibrated based on actual staff availability and patient demand?

A study conducted a few years ago by the WHO Collaborating Centre for Epidemiology and Community Dentistry
showed that the average daily time spent using a dental unit in the Public Service is about 3 hours. The time spent on
the dental unit turns out to be about half that of a health professionals’ work shift (7.36 hours) established for medical
management by the CCNL’s health area (this is not valid for departmental chiefs). The same concept is true for the as-
sistance staff, of the health care professionals, (7.12 hours) working in the dental team.

In addition, once the opening time of the dental service is defined, the agendas must be set based on the time space
established for each service, which is characterized by a known execution time. This execution time considers not only
the average medical time but also some corrections (ancillary times).

However, many times this approach is still not used, indeed, in various situations what is seen is an “agenda personal-
ization”.

All of this shows that only with the application of simple scheduling rules, accompanied by the system’s monitoring and
control, we can ensure the delivery of the required services and expand the number of beneficiaries without the need of
further monetary expenses for the structure.

                                                                                               dr. Michele Nardone
                                                                                              Adda district director
                                                                                  Head of Corporate Dental Services
                                                                              ASST Melegnano e della Martesana (Mi)




10.59987/ads/2023.1.1-1                                                                                                      1
