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Ferlias N, Nielsen H, Andersen E, Stoustrup P. Lessons learnt on patient safety in dentistry through a 5-year nationwide database study on iatrogenic harm. Sci Rep 2024; 14:11436. [PMID: 38763944 PMCID: PMC11102909 DOI: 10.1038/s41598-024-62107-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/14/2024] [Indexed: 05/21/2024] Open
Abstract
Safe delivery of care is a priority in dentistry, while basic epidemiological knowledge of patient safety incidents is still lacking. The objectives of this study were to (1) classify patient safety incidents related to primary dental care in Denmark in the period 2016-2020 and study the distribution of different types of dental treatment categories where harm occurred, (2) clarify treatment categories leading to "nerve injury" and "tooth loss" and (3) assess the financial cost of patient-harm claims. Data from the Danish Dental Compensation Act (DDCA) database was retrieved from all filed cases from 1st January 2016 until 31st December 2020 pertaining to: (1) The reason why the patient applied for treatment-related harm compensation, (2) the event that led to the alleged harm (treatment category), (3) the type of patient-harm, and (4) the financial cost of all harm compensations. A total of 9069 claims were retrieved, of which 5079 (56%) were found eligible for compensation. The three most frequent categories leading to compensation were "Root canal treatment and post preparation"(n = 2461, 48% of all approved claims), "lack of timely diagnosis and initiation of treatment" (n = 905, 18%) and "surgery" (n = 878, 17%). Damage to the root of the tooth accounted for more than half of all approved claims (54.36%), which was most frequently a result of either parietal perforation during endodontic treatment (18.54%) or instrument fracture (18.89%). Nerve injury accounted for 16.81% of the approved claims. Total cost of all compensation payments was €16,309,310, 41.1% of which was related to surgery (€6,707,430) and 20.4% (€3,322,927) to endodontic treatment. This comprehensive analysis documents that harm permeates all aspects of dentistry, especially in endodontics and surgery. Neglect or diagnostic delays contribute to 18% of claims, indicating that harm does not solely result from direct treatment. Treatment harm inflicts considerable societal costs.
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Affiliation(s)
- Nikolaos Ferlias
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000, Aarhus, Denmark.
| | - Henrik Nielsen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Erik Andersen
- Private Practice, Colosseum Dental Group, Broendby, Copenhagen, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, 8000, Aarhus, Denmark
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2
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Obadan-Udoh E, Van der Berg-Cloete S, Ramoni R, Kalenderian E, White JG. Patient-Reported Dental Safety Events: A South African Perspective. J Patient Saf 2021; 17:e866-e873. [PMID: 29369072 DOI: 10.1097/pts.0000000000000464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES In recent years, there has been an increase in research studies highlighting patients' experiences of adverse events (AEs) as well as the role of patients in promoting safety. The primary goal of the study was to assess the prevalence of dental AEs (DAEs) among dental patients in South Africa and its associated factors. The integration of the patient perspective into dental patient safety research will enhance our collective understanding of DAEs. METHODS We conducted a cross-sectional study of adult patients at a large dental academic institution in South Africa from May to June 2015, evaluating their previous experiences of DAEs at any dental clinic in South Africa. Descriptive statistics and bivariate and multivariate analyses were performed to identify the factors associated with an increased likelihood of experiencing a DAE. RESULTS A total of 440 questionnaires were returned during the 6-week study period (response rate = 97.8%). Overall, 45.5% of participants reported experiencing one or more DAEs. Two hundred participants reported a total of 717 DAEs giving us a lifetime prevalence of 1.6 DAEs per respondent. Our results suggest that respondents who were younger (18-24 y), from high-income families (>R150,000 or US $9200), dissatisfied with their last dental visit and oral health had an increased likelihood of reporting a previous experience of a DAE. CONCLUSIONS This study provides an insight into the nature of information that can be gleaned from dental patients regarding safety and helps lay the foundation for patient involvement in patient safety reporting.
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Affiliation(s)
- Enihomo Obadan-Udoh
- From the Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, California
| | - Sophy Van der Berg-Cloete
- Department of Dental Management Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Rachel Ramoni
- Center for Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Elsbeth Kalenderian
- From the Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, California
| | - John George White
- Department of Dental Management Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
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3
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Ensaldo-Carrasco E, Sheikh A, Cresswell K, Bedi R, Carson-Stevens A, Sheikh A. Patient Safety Incidents in Primary Care Dentistry in England and Wales: A Mixed-Methods Study. J Patient Saf 2021; 17:e1383-e1393. [PMID: 34852417 DOI: 10.1097/pts.0000000000000530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In recent decades, there has been considerable international attention aimed at improving the safety of hospital care, and more recently, this attention has broadened to include primary medical care. In contrast, the safety profile of primary care dentistry remains poorly characterized. OBJECTIVES We aimed to describe the types of primary care dental patient safety incidents reported within a national incident reporting database and understand their contributory factors and consequences. METHODS We undertook a cross-sectional mixed-methods study, which involved analysis of a weighted randomized sample of the most severe incident reports from primary care dentistry submitted to England and Wales' National Reporting and Learning System. Drawing on a conceptual literature-derived model of patient safety threats that we previously developed, we developed coding frameworks to describe and conduct thematic analysis of free text incident reports and determine the relationship between incident types, contributory factors, and outcomes. RESULTS Of 2000 reports sampled, 1456 were eligible for analysis. Sixty types of incidents were identified and organized across preoperative (40.3%, n = 587), intraoperative (56.1%, n = 817), and postoperative (3.6%, n = 52) stages. The main sources of unsafe care were delays in treatment (344/1456, 23.6%), procedural errors (excluding wrong-tooth extraction) (227/1456; 15.6%), medication-related adverse incidents (161/1456, 11.1%), equipment failure (90/1456, 6.2%) and x-ray related errors (87/1456, 6.0%). Of all incidents that resulted in a harmful outcome (n = 77, 5.3%), more than half were due to wrong tooth extractions (37/77, 48.1%) mainly resulting from distraction of the dentist. As a result of this type of incident, 34 of the 37 patients (91.9%) examined required further unnecessary procedures. CONCLUSIONS Flaws in administrative processes need improvement because they are the main cause for patients experiencing delays in receiving treatment. Checklists and standardization of clinical procedures have the potential to reduce procedural errors and avoid overuse of services. Wrong-tooth extractions should be addressed through focused research initiatives and encouraging policy development to mandate learning from serious dental errors like never events.
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Affiliation(s)
- Eduardo Ensaldo-Carrasco
- From the Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh
| | - Asiyah Sheikh
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, Scotland
| | - Kathrin Cresswell
- From the Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh
| | - Raman Bedi
- King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, King's College London, United Kingdom
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4
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Kalenderian E, Obadan-Udoh E, Maramaldi P, Etolue J, Yansane A, Stewart D, White J, Vaderhobli R, Kent K, Hebballi NB, Delattre V, Kahn M, Tokede O, Ramoni RB, Walji MF. Classifying Adverse Events in the Dental Office. J Patient Saf 2021; 17:e540-e556. [PMID: 28671915 PMCID: PMC5748012 DOI: 10.1097/pts.0000000000000407] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dentists strive to provide safe and effective oral healthcare. However, some patients may encounter an adverse event (AE) defined as "unnecessary harm due to dental treatment." In this research, we propose and evaluate two systems for categorizing the type and severity of AEs encountered at the dental office. METHODS Several existing medical AE type and severity classification systems were reviewed and adapted for dentistry. Using data collected in previous work, two initial dental AE type and severity classification systems were developed. Eight independent reviewers performed focused chart reviews, and AEs identified were used to evaluate and modify these newly developed classifications. RESULTS A total of 958 charts were independently reviewed. Among the reviewed charts, 118 prospective AEs were found and 101 (85.6%) were verified as AEs through a consensus process. At the end of the study, a final AE type classification comprising 12 categories, and an AE severity classification comprising 7 categories emerged. Pain and infection were the most common AE types representing 73% of the cases reviewed (56% and 17%, respectively) and 88% were found to cause temporary, moderate to severe harm to the patient. CONCLUSIONS Adverse events found during the chart review process were successfully classified using the novel dental AE type and severity classifications. Understanding the type of AEs and their severity are important steps if we are to learn from and prevent patient harm in the dental office.
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Affiliation(s)
| | | | | | - Jini Etolue
- Harvard School of Dental Medicine, Boston, MA, USA
| | - Alfa Yansane
- University of California, San Francisco, School of Dentistry, CA, USA
| | - Denice Stewart
- Oregon Health & Science University, School of Dentistry, Portland, OR, USA
| | - Joel White
- University of California, San Francisco, School of Dentistry, CA, USA
| | - Ram Vaderhobli
- University of California, San Francisco, School of Dentistry, CA, USA
| | - Karla Kent
- Oregon Health & Science University, School of Dentistry, Portland, OR, USA
| | - Nutan B. Hebballi
- University of Texas Health Science Center, School of Dentistry at Houston, Houston, TX, USA
| | - Veronique Delattre
- University of Texas Health Science Center, School of Dentistry at Houston, Houston, TX, USA
| | - Maria Kahn
- Harvard School of Dental Medicine, Boston, MA, USA
| | | | - Rachel B. Ramoni
- Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Muhammad F. Walji
- University of Texas Health Science Center, School of Dentistry at Houston, Houston, TX, USA
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5
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Roerig M, Farmer J, Ghoneim A, Gomaa N, Dempster L, Evans K, La W, Quiñonez C. Developing a coding taxonomy to analyze dental regulatory complaints. BMC Health Serv Res 2020; 20:1083. [PMID: 33239029 PMCID: PMC7691083 DOI: 10.1186/s12913-020-05943-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/19/2020] [Indexed: 11/29/2022] Open
Abstract
Background As part of their mandate to protect the public, dental regulatory authorities (DRA) in Canada are responsible for investigating complaints made by members of the public. To gain an understanding of the nature of and trends in complaints made to the Royal College of Dental Surgeons of Ontario (RCDSO), Canada’s largest DRA, a coding taxonomy was developed for systematic analysis of complaints. Methods The taxonomy was developed through a two-pronged approach. First, the research team searched for existing complaints frameworks and integrated data from a variety of sources to ensure applicability to the dental context in terms of the generated items/complaint codes in the taxonomy. Second, an anonymized sample of complaint letters made by the public to the RCDSO (n = 174) were used to refine the taxonomy. This sample was further used to assess the feasibility of use in a larger content analysis of complaints. Inter-coder reliability was also assessed using a separate sample of letters (n = 110). Results The resulting taxonomy comprised three domains (Clinical Care and Treatment, Management and Access, and Relationships and Conduct), with seven categories, 23 sub-categories, and over 100 complaint codes. Pilot testing for the feasibility and applicability of the taxonomy’s use for a systematic analysis of complaints proved successful. Conclusions The resulting coding taxonomy allows for reliable documentation and interpretation of complaints made to a DRA in Canada and potentially other jurisdictions, such that the nature of and trends in complaints can be identified, monitored and used in quality assurance and improvement. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-05943-7.
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Affiliation(s)
- Monika Roerig
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Julie Farmer
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada.
| | - Abdulrahman Ghoneim
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Noha Gomaa
- Oral Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Laura Dempster
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Krystal Evans
- Royal College of Dental Surgeons of Ontario, Toronto, Canada
| | - Wanda La
- Royal College of Dental Surgeons of Ontario, Toronto, Canada
| | - Carlos Quiñonez
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Canada
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Corrêa CDTSDO, Sousa P, Reis CT. Patient safety in dental care: an integrative review. CAD SAUDE PUBLICA 2020; 36:e00197819. [PMID: 33084835 DOI: 10.1590/0102-311x00197819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/29/2020] [Indexed: 11/22/2022] Open
Abstract
Adverse events pose a serious problem for quality of healthcare. Dental practice is eminently invasive and involves close and routine contact with secretions; as such, it is potentially prone to the occurrence of adverse events. Various patient safety studies have been developed in the last two decades, but mostly in the hospital setting due to the organizational complexity, severity of the cases, and diversity and specificity of the procedures. The objective was to identify and explore studies on patient safety in Dentistry. An integrative literature review was performed in MEDLINE via PubMed, Scopus via Portal Capes, and the Regional Portal of the Virtual Health Library, using the terms patient safety and dentistry in English, Spanish, and Portuguese, starting in 2000. The research cycle in patient safety was used, as proposed by the World Health Organization to classify studies. We analyzed 91 articles. The most common adverse events were allergies, infections, diagnostic delay or failure, and technical error. Measures to mitigate the problem highlight the need to improve communications, encourage reporting, and search for tools to assist the management of care. The authors found a lack of studies on implementation and assessment of the impact of proposals for improvement. Dentistry has made progress in patient safety but still needs to transpose the results into practice, where efforts are crucial to prevent adverse events.
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Affiliation(s)
| | - Paulo Sousa
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal.,Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
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7
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Al-Mahalawy H, El-Mahallawy Y, El Tantawi M. Dentists' practices and patient safety: A cross-sectional study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:381-389. [PMID: 32053278 DOI: 10.1111/eje.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/28/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess the frequency of dentist-reported practices to ensure patient safety in the dental office and the impact of training and work environment on this frequency using the framework of the International Patient Safety Goals (IPSGs). METHODS Dentists attending major conferences in Egypt and Saudi Arabia were recruited in a cross-sectional study in 2018. They completed a questionnaire assessing professional background and the frequency of practices for the IPSGs. The relationship between explanatory variables: training (postgraduate degrees and continuing education) and work environment (years in profession, working in public sector and performing surgical procedures) and the outcome variable: frequency of practices for 4 IPSGs was assessed using multivariate general linear model, and univariate general linear model was used to assess their relationship to the overall score of safety practices calculated for all goals. RESULTS The response rate was 81.1%. Practices related to reducing harm in the office environment were significantly less frequent than practices ensuring medication safety, ensuring safe surgery and controlling infection. The overall frequency of safety practices was significantly higher amongst senior than junior dentists. There were significant differences in safety practices frequency based on postgraduate degrees and receiving safety training. Dentists performing surgical procedures reported less frequent safety practices. CONCLUSION Practices to reduce harm because of the dental office environment were less frequent than other safety practices. Senior dentists, dentists who had postgraduate degrees and who received safety training reported more safety practices whilst those performing surgical procedures reported fewer safety practices.
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Affiliation(s)
- Haytham Al-Mahalawy
- Biomedical Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yehia El-Mahallawy
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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8
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Zare M, Afifi S, Karimzadeh I, Salehi-Marzijarani M, Zarei L, Ghazipour G, Mirjalili M, Lankarani KB, Sabzghabaee AM, Ahmadizar F, Peymani P. A Population-Based Study on Patients Complaining Regarding Community Pharmacies Services. J Res Pharm Pract 2020; 9:88-93. [PMID: 33102382 PMCID: PMC7547744 DOI: 10.4103/jrpp.jrpp_19_82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/05/2020] [Indexed: 02/05/2023] Open
Abstract
Objective: Patients’ complain regarding pharmaceutical services at community pharmacies is a fundamental issue as it can directly affect people's service utilization. For the first time in Iran, this survey aimed to investigate the experience of people regarding declare a complaint against the pharmacy sectors as a community-based study. Methods: In this cross-sectional study, over 100 samples based on postal codes were randomly selected from the city of Shiraz in 2017–2018. The data collection instrument was designed in two parts (demographic and social profile which record the complaint experiences against pharmacists, pharmacy services, etc.). The data were analyzed by SPSS. Findings: All 1035 eligible participants had a mean age of 45.54 ± 15.82 years (ranged from 14 to 91). Nearly 70% of the participants were female. Around 81.8% had a family physician coverage, whereas 7.4% of them had no medical insurance coverage. The frequency of complaints from the pharmacies was 35.6%. Nearly 55% of the complaints were related to governmental pharmacies. Homemakers were 1.36 times more likely to have experienced complaints in comparison with their employed female counterparts. Health status had an inverse association with complaints. Those participants who had received prescription medication were about two times more likely to have filed a complaint in comparison with those who received medication without a prescription. In addition, females aged 40–59 and above 60 and unemployed participants were more satisfied with respect to complaint follow-up process. Conclusion: Low level of satisfaction with respect to the complaint process is a concerning issue; hence, strategies are warranted to improve the quality of services provided in the pharmacies.
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Affiliation(s)
- Marziyeh Zare
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saba Afifi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Karimzadeh
- Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Leila Zarei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Ghazipour
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtabalsadat Mirjalili
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mohammad Sabzghabaee
- Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Ahmadizar
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Payam Peymani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Clinical Pharmacology and Toxicology, University Hospital Zurich-University of Zurich, Switzerland
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9
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Almufleh B, Ducret M, Malixi J, Myers J, Nader SA, Franco Echevarria M, Adamczyk J, Chisholm A, Pollock N, Emami E, Tamimi F. Development of a Checklist to Prevent Reconstructive Errors Made By Undergraduate Dental Students. J Prosthodont 2020; 29:573-578. [PMID: 32282105 DOI: 10.1111/jopr.13177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/22/2020] [Accepted: 04/04/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To design a checklist in order to reduce the frequency of reconstructive preventable errors (PE) performed by undergraduate dental students at McGill University. MATERIALS AND METHODS The most common PE occurring at a university dental clinic were identified by three reviewers analyzing the refunded cases, and used to create a preliminary checklist. This checklist was then validated by a panel of dental educators to produce a finalized 20-item checklist. The 20-question checklist was then submitted to students in a cross-sectional survey-based study to evaluate its relevance to undergraduate clinical education needs. RESULTS As many as 81% of students reported to have forgotten at least one item of the checklist during care of their last patient, and the most forgotten checklist items corresponded to the pretreatment stage. The students also reported that 17 of the 20 items in the checklist were relevant to a considerable extent or highly relevant. CONCLUSION Common PE identified in the undergraduate clinic could be used to create a checklist of relevant items designed to reduce errors made by students and practitioners performing prosthodontic and reconstructive treatments. However, further studies are required to evaluate the implementation and efficiency of the checklist.
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Affiliation(s)
- Balqees Almufleh
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,King Saud University, Riyadh, Saudi Arabia
| | - Maxime Ducret
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Faculty of Dentistry, Lyon 1 University, Lyon, France.,Odontology Center, Lyon Civils Hospices, Lyon, France
| | - Jodeci Malixi
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Jeffrey Myers
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Samer Abi Nader
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | | | - Jessica Adamczyk
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Alicia Chisholm
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Natalie Pollock
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,College of Dental Medicine, Qatar University, Doha, Qatar
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10
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Affiliation(s)
- Tara Renton
- Kings College Hospital‐Oral Surgery University of London London UK
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11
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Choi EM, Mun SJ, Chung WG, Noh HJ. Relationships between dental hygienists' work environment and patient safety culture. BMC Health Serv Res 2019; 19:299. [PMID: 31077202 PMCID: PMC6509757 DOI: 10.1186/s12913-019-4136-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patient safety culture is a core factor in increasing patient safety, is related to the quality of medical service, and can lower the risk of patient safety accidents. However, in dentistry, research has previously focused mostly on reporting of patient safety accidents. Dental professionals' patient safety culture must therefore first be assessed, and related factors analyzed to improve patient safety. METHODS This cross-sectional study completed a survey on 377 dental hygienists working in dental settings. To assess patient safety culture, we used a survey with proven validity and reliability by translating the Hospital Survey on Patient Safety Culture (HSOPS) developed by Agency for Healthcare Research and Quality (AHRQ) into Korean. Response options on all of the items were on 5-point Likert-type scales. SPSS v21 was used for statistical analysis. The relationships between workplace factors and patient safety culture were examined using t-tests and one-way analysis of variance (ANOVA) tests(p < 0.05). RESULTS The work environment of dental hygienists has a close relationship with patient safety. Dental hygienists working ≥40 h/week in Korea had a significantly lower for patient safety grade than those working < 40 h/week. When the number of patients per day was less than 8, the safety level of patients was significantly higher. And significant differences were found depending on institution type, institution size. CONCLUSIONS In order to establish high-quality care and patient safety system practical policies must be enacted. In particular, assurance in the quality of work environment such as sufficient staffing, appropriate work hours, and enough rest must first be realized before patient safety culture can easily be formed.
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Affiliation(s)
- Eun-Mi Choi
- Department of Dental Hygiene, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - So-Jung Mun
- Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsanro, Wonju, Kangwondo, 26426, Republic of Korea
| | - Won-Gyun Chung
- Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsanro, Wonju, Kangwondo, 26426, Republic of Korea
| | - Hie-Jin Noh
- Department of Dental Hygiene, Yonsei University Wonju College of Medicine, 20 Ilsanro, Wonju, Kangwondo, 26426, Republic of Korea.
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Vehkalahti MM, Swanljung O. Operator-related aspects in endodontic malpractice claims in Finland. Acta Odontol Scand 2017; 75:155-160. [PMID: 28049372 DOI: 10.1080/00016357.2016.1272000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We analyzed operator-related differences in endodontic malpractice claims in Finland. MATERIALS AND METHODS Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002-2006 and 2011-2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient's age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist's age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses. RESULTS Patients' mean age was 44.7 (range 8-85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients' gender, dentists' age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator's age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists. CONCLUSIONS Operator-related factors had no impact on endodontic malpractice claims.
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Affiliation(s)
- Miira M. Vehkalahti
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Outi Swanljung
- Department of Oral Health Care, The Patient Insurance Centre, Helsinki, Finland
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Lee YH, Chen CCC, Lee SK, Chen CY, Wan YL, Guo WY, Cheng A, Chan WP. Patient safety during radiological examinations: a nationwide survey of residency training hospitals in Taiwan. BMJ Open 2016; 6:e010756. [PMID: 27650758 PMCID: PMC5051322 DOI: 10.1136/bmjopen-2015-010756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 06/21/2016] [Accepted: 09/02/2016] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Variations in radiological examination procedures and patient load lead to variations in standards of care related to patient safety and healthcare quality. To understand the status of safety measures to protect patients undergoing radiological examinations at residency training hospitals in Taiwan, a follow-up survey evaluating the full spectrum of diagnostic radiology procedures was conducted. DESIGN Questionnaires covering 12 patient safety-related themes throughout the examination procedures were mailed to the departments of diagnostic radiology with residency training programmes in 19 medical centres (with >500 beds) and 17 smaller local institutions in Taiwan. After receiving the responses, all themes in 2014 were compared between medical centres and local institutions by using χ(2) or 2-sample t-tests. PARTICIPANTS Radiology Directors or Technology Chiefs of medical centres and local institutions in Taiwan participated in this survey by completing and returning the questionnaires. RESULTS The response rates of medical centres and local institutions were 95% and 100%, respectively. As indicated, large medical centres carried out more frequent clinically ordered, radiologist-guided patient education to prepare patients for specific examinations (CT, 28% vs 6%; special procedures, 78% vs 44%) and incident review and analysis (89% vs 47%); however, they required significantly longer access time for MRI examinations (7.00±29.50 vs 3.50±3.50 days), had more yearly incidents of large-volume contrast-medium extravasation (2.75±1.00 vs 1.00±0.75 cases) and blank radiographs (41% vs 8%), lower monthly rates of suboptimal (but interpretable) radiographs (0.00±0.01% vs 0.64±1.84%) and high-risk reminder reporting (0.01±0.16% vs 1.00±1.75%) than local institutions. CONCLUSIONS Our study elucidates the status of patient safety in diagnostic radiology in Taiwan, thereby providing helpful information to improve patient safety guidelines needed for medical imaging in the future.
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Affiliation(s)
- Yuan-Hao Lee
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | | | - San-Kan Lee
- Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Yu Chen
- Department of Radiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yung-Liang Wan
- Institute for Radiological Research, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wan-Yuo Guo
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Amy Cheng
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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