Introduction ‘Quality’ in primary care dentistry is poorly defined. There are significant international efforts focussed on developing quality measures within dentistry. The aim of this research was to identify measures used to assess quality in primary care dentistry and categorise them according to which dimensions of quality they attempt to measure. Methods Quality measures were identified from the peer‐reviewed and grey literature. Peer‐reviewed papers describing the development and validation of measures were identified using a structured literature search. Measures from the grey literature were identified using structured searches and direct contact with dental providers and institutions. Quality measures were categorised according to domains of structure, process and outcome and by disaggregated dimensions of quality. Results From 22 studies, 11 validated measure sets (comprising nine patient satisfaction surveys and two practice assessment instruments) were identified from the peer‐reviewed literature. From the grey literature, 24 measure sets, comprising 357 individual measures, were identified. Of these, 96 addressed structure, 174 addressed process and 87 addressed outcome. Only three of these 24 measure sets demonstrated evidence of validity testing. The identified measures failed to address dimensions of quality, such as efficiency and equity. Conclusions There has been a proliferation in the development of dental quality measures in recent years. However, this development has not been guided by a clear understanding of the meaning of quality. Few existing measures have undergone rigorous validity or reliability testing. A consensus is needed to establish a definition of quality in dentistry. Identification of the important dimension of quality in dentistry will allow for the production of a core quality measurement set.

The approach to quality improvement is more important than its definition. Valid indicators are required to measure quality, driven by a common approach. Information technology offers the opportunity to streamline the process of quality measurement to empower the dentist in primary care to take ownership of quality improvement.

The tooth eruption and wear (TEW) technique for aging wild European fallow deer (Dama dama dama) in Tasmania, Australia has been in use for >15 yr, but it is also subjective and relies on the skill of the assessor and their assumptions of tooth wear. Deer managers and hunters have suggested that the TEW patterns observed in Tasmania are not consistent with age predictions of deer based on male antler growth. The cementum annuli (CA) technique provides a more objective assessment of age, but is more costly to perform. Our objective was to examine the relationship between the TEW and CA techniques for estimating the age of wild fallow deer in Tasmania. A game manager experienced in the use of the TEW technique assigned 300 deer jawbones collected from 3 sites during the 2001–2006 hunting seasons in Tasmania to different age categories. We conducted preliminary trials to develop a protocol that reliably exposed the CA in incisor teeth. Finally, we compared the ages determined by both methods. The preliminary trials successfully developed a protocol to use incisor teeth for reliably assessing CA. The CA technique gave a higher putative age than the TEW technique, though the magnitude of this result was dependent on location. The amount of soil ingested by the animals, and whether the animals mainly browsed or grazed were possible reasons why tooth wear varied between locations. Whilst the CA method is effective at indicating the age of wild deer, the method should be proven against known‐aged deer before being offered as a definitive measure of age. Managers should be clear in their objectives whether they require an approximate guide to age or an objective measure of age before deciding on which method to use. © 2011 The Wildlife Society.

Background: Discharge from acute mental health inpatient units is often a vulnerable period for patients. Multiple professionals and agencies are involved and processes and procedures are not standardized, often resulting in communication delays and co-ordination failures. Early and appropriate discharge planning and standardization of procedures could make inpatient care safer.Aim: To inform the development of a multi-component best practice guidance for discharge planning (including the 6 component SAFER patient flow bundle) to support safer patient transition from mental health hospitals to the community.Methods: Using the RAND/UCLA Appropriateness method, a panel of 10 professional stakeholders (psychiatrists, psychiatric nurses, clinical psychologists, pharmacists, academics, and policy makers) rated evidence-based statements. Six hundred and sixty-eight statements corresponding to 10 potential components of discharge planning best practice were rated on a 9-point integer scale for clarity, appropriateness and feasibility (median ≥ 7–9) using an online questionnaire then remote online face-to-face meetings.Results: Five of the six “SAFER” patient flow bundle components were appropriate and feasible for inpatient mental health. One component, “Early Flow,” was rated inappropriate as mental health settings require more flexibility. Overall, 285 statements were rated as appropriate and feasible. Forty-four statements were considered appropriate but not feasible to implement.Discussion: This consensus study has identified components of a best practice guidance/intervention for discharge planning for UK mental health settings. Although some components describe processes that already happen in everyday clinical interactions (i.e., review by a senior clinician), standardizing such processes could have important safety benefits alongside a tailored and timely approach to post-discharge care.