Patients' Rights and Responsibilities

As a patient at Boston University School of Dental Medicine (BUSDM) I have the right to:

1. information regarding my diagnosis and treatment options and informed consent to the extent provided by law.
2. prompt and appropriate emergency treatment.
3. considerate and respectful dental care.
4. discuss my concerns with a patient advocate.
5. confidentiality of dental records and communications to the extent provided by law.
6. privacy when receiving dental care, within the ability of the facility.
7. prompt and adequate answers to reasonable requests and needs for treatment or service, within the capacity of BUSDM.
8. inspect my dental record in the presence of a patient advocate or dental faculty member, and receive a copy of my dental record for a reasonable fee, as prescribed by law.
9. refuse to serve as a research subject, or refuse to accept any treatment or examination when the primary purpose is educational or informational rather than therapeutic.
10. request and receive a copy of an itemized statement of my treatment and charges.
11. request and receive the name and specialty, if any, of all members of my treatment team.
12. request and receive an explanation as to BUSDM’s relationship, if any, with any other health care facility or educational institution as it relates to patient care.
13. obtain a copy of any rules or regulations of BUSDM which apply to my conduct as a patient of the facility.
14. request and receive from BUSDM a copy of information, if any which BUSDM has available relative to financial assistance and free care

As a patient of Boston University School of Dental Medicine (BUSDM), I understand I have the responsibility to:

1. provide, to the best of my knowledge, accurate and complete information about current medical complaints, past illnesses, hospitalizations, medicines and other issues relevant to my care, and changes to these.
2. inform my provider promptly if you do not understand information relating to my care and treatment or I receive instructions that I cannot comply with.
3. keep appointments, or telephone when I cannot keep a scheduled appointment.
4. observe BUSDM’s no smoking policy.
5. follow BUSDM’s rules and regulations.
6. provide information regarding changes in my dental insurance.
7. accept responsibility for my actions, if I refuse treatment or do not follow my provider’s instructions.
8. be considerate of other patients and BUSDM property
9. show courtesy and respect to BUSDM personnel
10. behave reasonably and appropriately, showing respect for the professional atmosphere of BUSDM
11. fulfill my financial responsibilities
    

Clinical Guidelines for Boston University School of Dental Medicine

revised March 2005

General Dentistry

Guideline : Evidence of informed consent (including written evidence) prior to receiving treatment.
Source : Patient Satisfaction Survey (PSS), Q. 9,10,11,12

Guideline : Patient’s chief complaint will be addressed.
Source : PSS, Q 14; PTE (Post-Treatment Evaluation) Q. 1

Guideline : Patient will be pain-free at conclusion of treatment.
Source : PSS, Q. 15; PTE, Q. 3

Guideline Patient will have a comprehensive treatment plan.
Source : Chart Audit (CA), Section G, Q. 59, 61

Guideline : Patient will receive intra-oral and extra-oral head/neck examination.
Source : CA, Q. 54

Guideline : All charts will contain adequate and up-to-date patient identification information.
Source : CA, Section A, Q. 1

Guideline : Patient’s diagnosis will be recorded in the chart.
Source : CA, Q. 55; Record Review (RR), Pre-record review data sheet.

Guideline : Patient will be given information regarding risks and benefits of treatment and non-treatment.
Source : PSS, Q. 9, 10, 11

Guideline : All charts will have medical history updated within the last calendar year.
Source : CA, Section B, Q. 7; RR, Pre-record review data sheet

Guideline : Charts will have diagnostic-quality radiographs.
Source : CA, Q. 32, 33, 34, 35, 36, 37

Guideline : Type and amount of anesthesia will be properly documented.
Source : CA, Section H, Q. 74

Endodontics

Guideline : Pre- and post-endodontic films will be present in the chart for endodontically treated teeth.
Source : PTE, Q. 17

Guideline: A restorative plan will be in place prior to definitive endodontic therapy.
Source: PTE, Q. 15' Note: Question on PTE has been modified: will be measured during next survey.

Guideline: Endodontically treated teeth will either be restored or a chart note will document the reason for incomplete treatment.
Source: PTE, Q. 14

Restorative Dentistry

Guideline: All treatment-planned teeth are restored to proper form, function, and patient’s acceptance of esthetics.
Source: PTE, Q. 12

Guideline: All treatment-planned edentulous areas are restored to proper form, function, and patient’s acceptance of esthetics (or a note in the chart as to why it was not).
Source: PTE, Q. 13

Periodontology

Guideline: On completion of treatment, the patient will exhibit no signs/symptoms of progression in periodontal disease as evidenced by adequate zones of attached gingiva.
Source: PTE, Q. 8

Guideline: On completion of treatment, the patient will exhibit no signs/symptoms of progression in periodontal disease as evidenced by maintainable periodontal topography.
Source: PTE, Q. 7

Guideline: On completion of treatment, the patient will exhibit no signs/symptoms of progression in periodontal disease as evidence by maintainable probing depths.
Source: PTE, Q. 5

Oral Surgery

Guideline: A request for consult will be written by referring department/provider, indicating service to be provided.
Source: CA, Q. 78

Guideline: All impacted teeth will be evaluated by Oral Surgery with documentation in the chart.
Source: PTE, Q. 19

Guideline: All bony and soft tissue lesions will be addressed by Oral Surgery/Oral Pathology.
Source: PTE, Q. 20

Guideline: Patients will experience lack of adverse clinical signs/symptoms at extraction or surgical site.
Source: PTE, Q. 18

Pediatric Dentistry

Guideline: The treatment plan will be signed by parent or guardian.
Source: CA, Q. 62

Guideline: Medical history form (within one year) is signed by parent or guardian and faculty.
Source: CA, Q. 6, 7, 9

Guideline: Appropriate space management evaluation will be documented.
Source: PTE: Q. 11 Note: Question on PTE has been modified: will be measured during next survey.

Guideline: Patient exhibits no clinical evidence of unaddressed caries.
Source: PTE, Q. 4

Orthodontic Dentistry

Guideline: Informed consent form signed by parent, guardian, or patient.
Source: CA, Q. 90

Guideline: Treatment contract signed by parent, guardian, or patient.
Source: CA, Q. 91

Guideline: Orthodontic chief complaint is satisfied.
Source: CA, Q. 92

Legend of Quality Assurance Measures

• PSS – Patient Satisfaction Survey
• PTE – Post-Treatment Evaluation
• CA – Chart Audit Form
• RR – Record Review

Patient Confidentiality Policy

Information known or contained in the patient’s dental record shall be treated as confidential and will be released in appropriate circumstances only with the written consent of the patient or legal guardian. All persons providing services at BUSDM who have access to information concerning patients including employees, staff, students and volunteers, must hold such information in strict confidence.


Procedure

I. Discussions/Conversations:

In the provision of quality care, dialogues involving patient care and treatment are inherent; however, discretion in public areas is very important. It is the responsibility of all employees, staff, students and volunteers to refrain from discussing patients in inappropriate places, e.g. elevators. This information should not be disclosed with anyone at BUSDM except those with a legitimate need to know the information in connection with patient care, clinic administration, or quality assurance. Confidential information should never be discussed with anyone outside of BUSDM. Conversations regarding patients in elevators and/or public areas are considered a breach of patient confidentiality.

II. Records

Information generated through contact between patients and health care providers at BUSDM is confidential. This confidentiality extends to all forms and formats in which the information is maintained and stored, including, but not limited to, hard copy, photocopy, microfilm, or automated/electronic form. The information on a patient’s dental chart is confidential and should not be disclosed without the patient’s knowledge and consent. There are occasions when there is a legal obligation or duty to disclose information. In order to protect the confidentiality of patient information and control dental records in the dental treatment areas, dental records must be signed out for authorized use whenever they are physically removed from the Record Room.

III. Protocol for Release of Patient Information:

All information contained in the patient’s record is confidential and shall be disclosed only to authorized persons in accordance with this policy. All requests for copies of information shall be handled by the Records Department. The Manager of Dental Records or his/her designee shall make the final decision on the release of information not covered by this policy, with the advice of the Office of General Counsel when appropriate. If the Manager or designee is unavailable , request for information should be referred to the Patient Services Representative.

This policy shall in no way interfere with the appropriate exchange of information between Departments/Providers. However, all BUSDM staff should be aware of the patient’s right to privacy and the University’s obligation to maintain the confidentiality of patient’s dental records and to act accordingly when responding to request for information.


The Patient’s Right to His/Her Record:

Although the dental record is the property of BUSDM, the patient has the right of access to information contained within the dental record. If the patient requests copies of his/her record, the Dental Record Department shall be notified. Upon presentation of a signed patient authorization and proper identification the Dental Records Department will process the request.
Violations: Violations are reported to the Dean of Clinical Affairs for appropriate
follow-up action.


Post Treatment Examination

Purpose - designed as a quality assurance measuring instrument, in addition to record review, patient survey and chart audit activities. It is designed to assess care that has been provided and the patient’s level of oral health

Process

1. During the last treatment appointment or recall appointment, faculty will conduct the post treatment evaluation.
2. The patient’s overall dental health status, as well as care provided to the patient as part of the treatment plan will be assessed as part of the post treatment evaluation.
3. The post treatment assessment will include evaluation for unresolved and untreated diseases as well as whether the standards of patient care have been achieved in a timely manner.
4. Each issue will be given a score 1-3. Any item receiving a score other than a 1 will require written comment and review by departmental faculty. An item scored at 2 points is ranked as unacceptable. An item scored at 3 points indicates that there is an issue requiring further review. Any item receiving a score of 2 or 3 will also require a chart note, detailing findings and plan for required follow-up.
5. If questions arise that cannot be resolved, a faculty member from the department involved will be asked to consult.
6. Faculty member will review accepted treatment plan to determine if additional dental services were offered and previously rejected by patient. Faculty member will discuss formerly suggested dental services to determine if patient is interested in receiving this treatment. Faculty member will also review the need for any additional treatment not previously discussed at treatment plan visit. Any item requiring treatment or retreatment, and is accepted by the patient, will be added to the treatment plan for follow-up and resolution.
7. Once the post treatment evaluation is complete the form will be submitted to the Quality Assurance Committee. The Quality Assurance Committee will collate results quarterly to identify trends in clinical services and providers and will report results to the Dental Health Committee.

Post Treatment Examination

Patient’s Name:_____________________________
Chart Number: ____________________

Date Completed: __________________
Reviewer’s Name (Print): ______________________
Reviewer’s Signature: ________________________________

Score: 1= acceptable 2= unacceptable 3=request departmental consultation
Score
General Dental Health
1. Chief complaint addressed ____
2. Patient satisfied with care/treatment ____
3. Patient currently pain free ____
4. Patient exhibits no clinical evidence of caries ____

Comments:____________________________
Periodontics
1. No signs/symptoms of progressive periodontal disease as evidenced by:
maintainable probing depths ____
maintainable topography ____
adequate zones of attached gingiva ____
absence of clinical signs of occlusal trauma ____
2. The patient exhibits no sign of severe gingiva inflammation ____
3. The level of gingival inflammation and plaque accumulation is
compatible with current frequency of recalls ____
4. Patient is aware of appropriate recall interval ____

Comments:____________________________
Pre Doctoral Orthodontics
1. Chief complaint addressed ____
2. Treatment plan completed ____
3. Patient satisfied with treatment ____

Comments:_________________________________

Score: 1= acceptable 2=unacceptable 3=request departmental consultation

Restorative
1. All treatment planned teeth are restored to form,
function and patient’s acceptance of esthetics ____
2. All treatment planned edentulous areas are restored
to form, function and patient’s acceptance of esthetics ____
3. Lack of adverse clinical signs/symptoms ____

Comments:____________________________
Endodontics
1. Lack of adverse clinical signs /symptoms ____
2. Radiographic evidence of dense 3 dimensional filling of the root canal system
which extends as close as possible to the radiographic terminus of the canals ____

Comments:_________________________
Oral Surgery
1. Lack of adverse clinical signs/symptoms at extraction or surgical site ____
2. Impacted teeth have been addressed by Oral Surgery ____
3. All bony and soft tissue lesions have been addressed ____

Comments:___________________________
Treatment recommendations previously declined by patient at treatment plan visit:
_____________________________________
Additional treatment recommendations (not previously offered to patient):

_____________________________________
Additional treatment accepted by patient
Additional treatment declined by patient
Patient referred for recall
Patient referred for evaluation:


Ryan White Treatment Fund: Fact Sheet for Dental Students

What is the Ryan White Treatment Fund?

The Ryan White Treatment Fund is a Federally funded program for people who have HIV and either have no dental insurance, or can verify that a procedure will not be covered by an existing dental insurance. Other dental coverage, such as MassHealth, must be billed for dental treatment.


How does a patient enroll?

To be eligible, a patient must complete an application form and provide medical verification of HIV status. A patient is not automatically registered for the Ryan White Treatment Fund, because they have HIV. There is no cost to enroll in the Ryan White Treatment Fund. See Elyse Holsberg to find out if your patient is enrolled in the Ryan White Treatment Fund.

Do I need prior approval?

You must receive prior approval when treating a patient on the Ryan White Treatment Fund. See Elyse Holsberg (G-708) once the treatment plan is written.

What does it cover?

The Ryan White Treatment Fund covers a wide range of dental procedures including:

• routine dental exams cleanings
• radiographs consults
• amalgam fillings composite fillings (anterior teeth)
• periodontic treatments endodontic treatments
• post and core crowns
• bridge dentures
• extraction

The Ryan White Treatment Fund does not pay for implant dentistry, orthodontics and dental procedures primarily for cosmetic purposes. The treatment fund cannot pay for dental care received prior to enrollment.


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