by Dr. Katherine Schrubbe reflects on her 40-year career in dentistry, including her role in quality assurance.
Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is a firm believer in lifelong learning. So, it’s no surprise that what began as a career in dental hygiene steadily evolved, as she completed several graduate-level degrees, became an expert on quality assurance and risk management, and eventually came full circle to her original place of employment, but in a new role.
Schrubbe joined Milwaukee, Wis.-based Dental Associates as a full-time hygienist nearly 40 years ago. Soon after, she joined the faculty at Marquette University School of Dentistry, Milwaukee, teaching part time while continuing to work in private practice. While at Marquette, she earned a master’s degree, followed by a PhD, which she began in 2000. Her doctoral research focused on health disparities and an assessment of oral health in low socio-economic populations over a 100-year span. Toward the completion of her PhD, she accepted a full-time position at Marquette’s School of Dentistry in the department of clinical services, with oversight of quality assurance, risk management and, shortly afterward, compliance. Following a 10-year administrative stint, in 2013 Schrubbe returned to private practice – and to Dental Associates, , by then a large group practice – with a new title: director of quality assurance.
Efficiency in Group Practice spoke with Dr. Schrubbe about her career, the role of infection prevention in dentistry and the future of the industry.
Efficiency in Group Practice: How did you become interested in clinical regulatory compliance?
Dr. Katherine Schrubbe: My responsibility for clinical regulatory compliance originally fell into my lap when I accepted my full-time position in the department of clinical services at Marquette University School of Dentistry. My own clinical education and training on compliance and infection control was sound, and I soon found myself enjoying teaching students and external practitioners about the importance of OSHA compliance, health and safety. I became more and more interested in the topic, and today I continue to provide continuing education programs on OSHA and infection control, as well as contribute to scientific journals on this content. In my role as director of quality assurance, I have oversight of clinical regulatory compliance, which is an integral piece of quality assurance and provides the foundation for safe patient care.
EGP: In your opinion, what progress has the dental profession made in infection prevention over the past 10-15 years?
Schrubbe: I believe there has been steady progress for infection prevention in dentistry. The Bloodborne Pathogens Standard provides federal standards for healthcare worker safety and to reduce risk of disease transmission. The Centers for Disease Control and Prevention (CDC) has led the way in providing sound guidelines and recommendations for dental healthcare personnel health and patient safety, and the scientific literature is full of related information on this topic. In 2003, the third formal document outlining procedures and protocols necessary was published: Guidelines for Infection Control in Dental Health-Care Settings. Most recently, in March 2016, the CDC released Summary of Infection Prevention Practices in Dental Settings – Basic Expectations for Safe Care. The summary and checklist is a supplement and companion to the 2003 Guidelines and provides a method for assessment of administrative policies and dental team personnel. For today’s dental practices, there is an abundance of resources on infection control and prevention.
EGP: What have you found most fulfilling about your work in the dental industry?
Schrubbe: I have been fortunate to experience a lot of diversity in my dental career, with careers in clinical private practice, academia and currently in a corporate setting. In each of these environments, fulfillment comes in different ways, including working with an office team to help each patient achieve the best oral health possible; teaching students a new skill and watching them grow to master it; and, today, working with an excellent executive team to enhance the patient experience, as well as being a resource for our dental providers. At Dental Associates, our mission is – to improve our patient’s quality of life through excellence in oral health care. Each day we strive to fulfill our mission, and fulfillment comes through positive feedback from our patients.
EGP: How did you come to rejoin Dental Associates?
Schrubbe: I returned to Dental Associates in 2013. I knew a lot about how the practice has grown, having worked there years before. And, I believed in their model of comprehensive dental care, where general dentists and specialists are able to confer and provide the best patient care under one roof. Dental Associates was established in 1973 and is Wisconsin’s largest family-owned dental group practice, with 14 in-state dental centers. My team is comprised of a compliance specialist and three corporate trainers. My responsibilities include oversight of the practice’s quality assurance, risk management and compliance programs, as well as continuing education programming and our corporate trainers, who provide all new staff orientation, on-boarding and other special training. As a large group practice, we are committed to efficiency and excellence in patient care. Dental Associates is nationally accredited by the Accreditation Association for Ambulatory Health Care (AAAHC), which means it has met the standards for providing high-quality patient care. More importantly, we demonstrate our commitment through on-going self-evaluation, peer review and education to continuously improve our services and care to patients. We take patient feedback very seriously. In 2014, Dental Associates received the Press Ganey Leaders in Transparency Award, which honors innovative healthcare organizations that have implemented solutions to capture the voice of patients and have shared patient experiences online.
EGP: What are the greatest changes we can expect to see in the dental industry in years to come?
Schrubbe: While we can’t anticipate everything, one thing is for certain: The dental practice model is changing. Over the past few years, it is estimated that dental support organizations have grown between 20-25 percent The literature reports that by 2020, only about a third of dental offices are expected to be solo practices. Patients already have more options for obtaining dental care, and competition will continue to increase. The good news is that large group practices such as ours can be quite efficient. They have the infrastructure and key people in place to better ensure compliance to federal and state laws, as well as professional standards of care.
Along with changes in the practice models, there have been changes in provider types, such as the addition of mid-level providers. According to the American Dental Hygienist’s Association (ADHA), there are about 13 States that have an Oral Health Workforce Model utilizing providers with titles such as, advanced dental therapist, advanced dental hygiene practitioner, advanced practice dental hygienist and more. The driving force behind this effort was a desire to better assist the nation’s underserved dental population. The addition of this new provider in dentistry has changed the landscape, but it is difficult to assess the results and where mid-level providers will be most utilized in the future.
Editor’s note: Look for Dr. Schrubbe’s infection control column in future issues of EGP.
