Practice of quality management for dental handpiece processing based on FOCUS-PDCA programme

This study applies the find, organise, clarify, understand, select - plan, do, check and act (FOCUS-PDCA) programme to analyse factors affecting dental handpiece (DHP) processing quality and to optimise the workflow using this quality improvement framework.

A prospective observational study was conducted at the Affiliated Ruijin Hospital of Shanghai Jiaotong University School of Medicine. The study included 2,893 DHPs processed under a routine scheme between July and December 2021 (control group) and 3,032 DHPs processed under the FOCUS-PDCA programme scheme between January and June 2022 (intervention group). The sample size was calculated using the formula for comparing two proportions, aiming to detect a significant difference in processing quality with a power of 80% and an alpha level of 0.05.

The FOCUS-PDCA programme significantly improved pass rates for cleaning (chi-square [χ²] = 58.955, degree of freedom [df] = 1, P < 0.01), packaging (χ² = 27.835, df = 1, P < 0.01) and sterilisation (χ² = 89.584, df = 1, P < 0.01) compared with routine processing. Staff mastery of theoretical knowledge and operational skills was superior in the FOCUS-PDCA group (t = 16.871, df = 18, P < 0.01; t = 15.348, df = 18, P < 0.01, respectively). The implementation of the programme significantly reduced the incidence of mechanical failures, including bearing and clamping shaft issues (χ² = 5.730, df = 1, P < 0.05; χ² = 5.849, df = 1, P < 0.05, respectively). The satisfaction score for DHP processing quality was higher in the FOCUS-PDCA group, with a mean of 88.80 ± 5.88, compared with 65.13 ± 7.60 in the control group (t = 13.479, df = 58, P < 0.01).

Within the limitations of this study, applying the FOCUS-PDCA programme to DHP processing procedures effectively improved processing quality and reduced mechanical failures. To our knowledge, this is among the first reports applying FOCUS-PDCA to DHP processing in a hospital setting. Clinical doctors and nurses expressed high satisfaction with the quality of processing following the implementation of the improved protocols.