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Best practices in local health systems: focusing on the elderly's oral health

This study aimed to apply the best practices for the elderly's oral health care through the theoreticalmethodological framework "Interactive Domain Model of Best Practices in Health Promotion", which considers the interaction of domains (Underpinnings, Understanding of the Environment and Practice), as an action-research. An intervention at the Best Practice referential in a local health system was carried out through a systematic and critical reflection by the actors involved with local governance, examining its potential to transform current practices according to the principles of Health Promotion. Data were collected from focal groups formed by managers, health professionals and the elderly (20 subjects). The best practices were suggested built on the principles of the National Health Service, Family Health Strategy and Health Promotion. The process of development of Best Practices is based on the expectation that a higher oral health standard for the elderly could be reached by means of a change in organizational practices, as well as in health, research and evaluation practices. The possible change depends on the willingness of the actors involved as regards the careful consideration and analysis of current behaviors, procedures and scenarios. The driving force for the continuous improvement of practices is the commitment of the local governance with the principles of Health Promotion. It was possible to build an indicative set of practices on oral health of the elderly and to generate useful knowledge to afford the approach of the theoretical models to the reality, with a view to the transformation of such practices.

health care; elderly's health; oral health; health services for the elderly; health systems; Health Promotion


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