Feasibility of Electronic Health Record–Based Triggers in Detecting Dental Adverse Events

Kalenderian, Elsbeth; Obadan‐Udoh, Enihomo; Yansane, Alfa-Ibrahim; Kent, Karla S.; Hebballi, Nutan B.; Delattre, Veronique F.; Kookal, Krishna Kumar; Tokede, Oluwabunmi; White, Joel M.; Walji, Muhammad F.

doi:10.1055/s-0038-1668088

Cited by 25 publications

(26 citation statements)

References 22 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Electronic health record (EHR)-based triggers have been widely used in medicine in both inpatient (Hibbert et al 2016) and outpatient (Cantor et al 2007) settings to detect AEs in a variety of areas, including diagnostic errors (Murphy et al 2019), adverse drug events (Lim et al 2016), delayed follow-up of abnormal radiology findings (Murphy et al 2016), and harm in pediatric hospitalized patients (Stockwell et al 2015). Our pilot studies have also revealed the feasibility of using triggered electronic dental patient charts to detect AEs (Kalenderian et al 2013;Kalenderian et al 2018).…”

Section: Introductionmentioning

confidence: 94%

Finding Dental Harm to Patients through Electronic Health Record–Based Triggers

Walji

Yansane

Hebballi

et al. 2019

JDR Clinical & Translational Research

View full text Add to dashboard Cite

Background: Patients may be inadvertently harmed while undergoing dental treatments. To improve care, we must first determine the types and frequency of harms that patients experience, but identifying cases of harm is not always straightforward for dental practices. Mining data from electronic health records is a promising means of efficiently detecting possible adverse events (AEs). Methods: We developed 7 electronic triggers (electronic health record based) to flag patient charts that contain distinct events common to AEs. These electronic charts were then manually reviewed to identify AEs. Results: Of the 1,885 charts reviewed, 16.2% contained an AE. The positive predictive value of the triggers ranged from a high of 0.23 for the 2 best-performing triggers (failed implants and postsurgical complications) to 0.09 for the lowest-performing triggers. The most common types of AEs found were pain (27.5%), hard tissue (14.8%), soft tissue (14.8%), and nerve injuries (13.3%). Most AEs were classified as temporary harm (89.2%). Permanent harm was present in 9.6% of the AEs, and 1.2% required transfer to an emergency room. Conclusion: By developing these triggers and a process to identify harm, we can now start measuring AEs, which is the first step to mitigating harm in the future. Knowledge Transfer Statement: A retrospective review of patients’ health records is a useful approach for systematically identifying and measuring harm. Rather than random chart reviews, electronic health record–based dental trigger tools are an effective approach for practices to identify patient harm. Measurement is one of the first steps in improving the safety and quality of care delivered.

show abstract

Section: Introductionmentioning

confidence: 94%

Finding Dental Harm to Patients through Electronic Health Record–Based Triggers

Walji

Yansane

Hebballi

et al. 2019

JDR Clinical & Translational Research

View full text Add to dashboard Cite

show abstract

“…While the first studies in patient safety aimed to measure the incidence or prevalence of AE to know the problem's magnitude 6 , the initial studies in Dentistry, besides measuring their frequency, aimed to understand their causes, sparking reflection on the inherent challenges in the specificities of dental practice. From the perspective of measuring the incidence/prevalence of harms, the studies 12,21,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43 produced findings that ranges from the complications of local anesthesia/sedation; lesions to the tongue and lips; and loss of teeth from switched tooth extractions, ocular lesions and even death. Incidents involved allergies, infections, diagnostic delay or failure, and failure in the procedure, among others.…”

Section: The Problem's Size and Understanding Its Causesmentioning

confidence: 99%

Segurança do paciente no cuidado odontológico: revisão integrativa

2020

View full text Add to dashboard Cite

Resumo: Eventos adversos constituem grave problema relacionado à qualidade do cuidado de saúde. A prática odontológica, por ser eminentemente invasiva e implicar contato íntimo e rotineiro com secreções, é potencialmente propícia à ocorrência desses eventos. Diversos estudos em segurança do paciente foram desenvolvidos nas duas últimas décadas, entretanto, em maior número no ambiente hospitalar, em função de sua complexidade organizacional, gravidade de casos, diversidade e especificidade de procedimentos. O objetivo foi identificar e explorar os estudos voltados à segurança do paciente odontológico. Foi realizada revisão integrativa da literatura com consulta ao MEDLINE via PubMed, Scopus via Portal Capes e ao Portal Regional da Biblioteca Virtual de Saúde, utilizando-se os termos segurança do paciente e odontologia nos idiomas inglês, espanhol e português a partir de 2000. Utilizou-se o ciclo de pesquisa em segurança do paciente, proposto pela Organização Mundial da Saúde para classificar os estudos incluídos. Foram analisados 91 artigos. Os eventos adversos mais comuns foram relacionados às alergias, às infecções, ao atraso ou falha de diagnóstico e ao erro da técnica. Medidas para mitigar o problema apontaram para a necessidade de melhoria da comunicação, incentivo à notificação e procura por instrumentos para auxiliar a gestão do cuidado. Constatou-se carência de estudos de implementação e avaliação de impacto das propostas de melhoria. A Odontologia evoluiu no campo da segurança do paciente, mas ainda está aquém de transpor resultados para a prática, sendo importante envidar esforços para prevenir os eventos adversos nesta área.

show abstract

“…Even when events are faithfully reported, identifying those events that are HIT-related remains a challenge. 24 Emerging methods for identification of patient safety events include automated datamining mechanisms [36][37][38][39][40] and simulation approaches. 41 Datamining based approaches have the benefit of utilizing data generated as a byproduct of clinical care (e.g., billing codes) to identify patient safety events in "real-time" with little human effort, 37 but they are susceptible to bias due to incomplete or inaccurate data.…”

Section: Approaches To Patient Safety Data Collectionmentioning

confidence: 99%

Development of a Taxonomy for Medication-Related Patient Safety Events Related to Health Information Technology in Pediatrics

et al. 2020

View full text Add to dashboard Cite

Background Although electronic health records (EHRs) are designed to improve patient safety, they have been associated with serious patient harm. An agreed-upon and standard taxonomy for classifying health information technology (HIT) related patient safety events does not exist. Objectives We aimed to develop and evaluate a taxonomy for medication-related patient safety events associated with HIT and validate it using a set of events involving pediatric patients. Methods We performed a literature search to identify existing classifications for HIT-related safety events, which were assessed using real-world pediatric medication-related patient safety events extracted from two sources: patient safety event reporting system (ERS) reports and information technology help desk (HD) tickets. A team of clinical and patient safety experts used iterative tests of change and consensus building to converge on a single taxonomy. The final devised taxonomy was applied to pediatric medication-related events assess its characteristics, including interrater reliability and agreement. Results Literature review identified four existing classifications for HIT-related patient safety events, and one was iteratively adapted to converge on a singular taxonomy. Safety events relating to usability accounted for a greater proportion of ERS reports, compared with HD tickets (37 vs. 20%, p = 0.022). Conversely, events pertaining to incorrect configuration accounted for a greater proportion of HD tickets, compared with ERS reports (63 vs. 8%, p < 0.01). Interrater agreement (%) and reliability (kappa) were 87.8% and 0.688 for ERS reports and 73.6% and 0.556 for HD tickets, respectively. Discussion A standardized taxonomy for medication-related patient safety events related to HIT is presented. The taxonomy was validated using pediatric events. Further evaluation can assess whether the taxonomy is suitable for nonmedication-related events and those occurring in other patient populations. Conclusion Wider application of standardized taxonomies will allow for peer benchmarking and facilitate collaborative interinstitutional patient safety improvement efforts.

show abstract

Feasibility of Electronic Health Record–Based Triggers in Detecting Dental Adverse Events

Cited by 25 publications

References 22 publications

Finding Dental Harm to Patients through Electronic Health Record–Based Triggers

Finding Dental Harm to Patients through Electronic Health Record–Based Triggers

Segurança do paciente no cuidado odontológico: revisão integrativa

Development of a Taxonomy for Medication-Related Patient Safety Events Related to Health Information Technology in Pediatrics

Contact Info

Product

Resources

About