How dental team members describe adverse events

Abstract

Background There is increased recognition that patients suffer adverse events (AEs) or harm caused by treatments in dentistry, and little is known about how dental providers describe these events. Understanding how providers view AEs is essential to building a safer environment in dental practice. Methods Dental providers and domain experts were interviewed through focus groups and in-depth interviews and asked to identify the types of AEs that may occur in dental settings. Results The first order listing of the interview and focus group findings yielded 1,514 items that included both causes and AEs. 632 causes were coded into one of the eight categories of the Eindhoven classification. 882 AEs were coded into 12 categories of a newly developed dental AE classification. Inter-rater reliability was moderate among coders. The list was reanalyzed and duplicate items were removed leaving a total of 747 unique AEs and 540 causes. The most frequently identified AE types were “Aspiration/ingestion” at 14% (n=142), “Wrong-site, wrong-procedure, wrong-patient errors” at 13%, “Hard tissue damage” at 13%, and “Soft tissue damage” at 12%. Conclusions Dental providers identified a large and diverse list of AEs. These events ranged from “death due to cardiac arrest” to “jaw fatigue from lengthy procedures”. Practical Implications Identifying threats to patient safety is a key element of improving dental patient safety. An inventory of dental AEs underpins efforts to track, prevent, and mitigate these events.

Self-perception of leadership style of dentists: heads of dental departments in community hospitals, Southern Thailand

“…Regarding the transactional leadership’s components, all items in the MBEA component were rated highly, indicating their frequent behaviour in monitoring mistakes. This could probably be due to the fact that dentists are worried about liability, and are quite averse to risky routine procedures and a large and diverse list of adverse events or harm that can be caused by dental treatment. Risk management or prevention is the most common defensive approach for dentists.…”

Inferior dental blocks versus infiltration dentistry: is it time for change?

“…5 It is important for clinicians to point out to patients that they are not magicians but surgeons and it is impossible to do complex surgery on patients without causing some minor discomfort intra-operatively and, occasionally, moderate pain post-operatively. Perioperative dental pain is not managed well in dentistry and is the most common adverse event reported by dentists 6,7 and by patients. 8 Regarding the dental experience involving pain, 60% of a representative sample of the general population aged 15 years or more has reported pain at least once during a dental visit.…”

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

“…14 Dentistry as a profession is slowly embracing the patient safety era, with a few dental care researchers focusing on AE reduction. [15][16][17] A "trigger" is an opportunity or clue to identify AEs in a patient's EHR. However, triggers themselves do not represent AEs.…”