Morbidity and Mortality Review in a University Dental Hospital: A Necessary Tool to Improve Quality of Care

Abstract

Objective The study aimed to describe and to analyze the first morbidity and mortality review (MMRs) set up within a Dental University Hospital using detailed case reports to highlight the benefits of MMRs for patients, practitioners, teachers and to implement appropriate protocols to prevent recurrence. Materials and Methods The MMRs were performed within the dentistry departments of the hospital over the 1-year study period. Each case was reviewed according to a protocol based on a tool defined by the Clinical Risk Unit and the Association of Litigation and Risk Management (ALARM). Results Four cases were selected based on an oral report by a doctor from the dental service, a downstream service, or by the attending physician. The first case report related to a patient who suffered a breathing shock. The second concerned a tooth inhalation by a young disabled boy. The third was a therapeutic failure instigated by a student during a tooth preparation, and the fourth case involved an unexpected face-to-face meeting between a prisoner accompanied by police guards and an ancient victim at the dental hospital. Discussion Clinical incidents were investigated with the ALARM protocol. This process is also less focused on the individual who makes the error and more on contributing systemic factors. The systematic analysis of cases associated with bibliographic reviews improves learning and performance outcomes. Clear answers were given in response to the problems raised during these MMRs. Conclusion In dental hospitals, the culture of MMRs needs to be integrated into resident training like in medical hospitals.

Is It Still Time for Safety Walkaround? Pilot Project Proposing a New Model and a Review of the Methodology

“…A morbidity and mortality review, historically introduced in surgical settings [ 19 ], is a peer review of medical records of adverse events such as death or complications that happened to a patient during hospitalization. In detail, it consists in assessing the management and comparing it to best evidence or guidelines from the literature to evaluate its appropriateness or to identify potential failures that may have contributed to the development of the complication [ 20 , 21 , 22 ].…”

A Pilot Study of Preparedness of Dentists in the United Arab Emirates to Deal with Medical Emergencies

“…Most of our participants (91.0%) knew how to deal with a patient who has syncope; this is not surprising, since syncope is the most prevalent emergency that occurs in the dental offices. 1 19 21 To the contrary, fewer dentists were able to manage correctly foreign-body aspiration by attempting Heimlich/Triple maneuver. Although it is a rare occurrence in the dental setting, knowledge about management of such a life-threatening medical emergency should not be disregarded.…”

“…It is inevitable that dentists may face medical emergencies in the dental clinics. 1 Anxiety associated with dental/surgical procedures including the administration of local anesthesia can induce medically emergent situation, such as syncope, hyperventilation, airway obstruction, anaphylaxis, and possible cardiac arrest. 2 3 For well-trained dentists in diagnosing conditions and treating patients in emergencies, the availability of essential emergency drugs and equipment can reduce the risks of detrimental outcomes associated with medical emergencies.…”

Ensuring Patient Safety in Pediatric Dental Care

“…The prima-ry goal of M&M sessions is to promote continuous learning, quality improvement, and patient safety within the healthcare organization [119]. Dental hospitals, similar to medical institutions [120], also need to integrate M&M sessions into dental resident education [121].…”