Oral Healthcare Research & Education Blog
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Using Surgical Safety Checklists to Protect Dental Patients from Never Events

Using Surgical Safety Checklists to Protect Dental Patients from Never Events

12/14/2016 5:01:04 PM   |   Comments: 0   |   Views: 170

While advancements in medical practice and broad healthcare standards have been increasing at a relatively steady rate over the course of the last two decades, there are a myriad of instances where routine procedures go awry. Whether due to miscommunication with the patient, a lack of training, or an error in judgment, medical missteps are still a concern across all areas of healthcare. In recent years, some advocates for patient safety have proposed shifts in the medical community to not only protect the individuals who seek out care, but for the doctors and staff who provide it as well.

Within the last decade, the National Patient Safety Agency (NPSA) in England identified a substantial list of largely preventable patient safety incidents that can cause serious harm. Known as Never Events, these issues, according to NPSA and other bodies, should not ever take place given the preventative measures that are standard protocol across medical providers in both the private and public sector. Should a Never Event occur, providers have the duty to report it on both a local and national level to NHS organisations as a tool to offer greater transparency while also prompting accountability for mistakes.

Wrong tooth extractions were initially a gray area for dental care providers, given the fact that they took place in a non-surgical setting in most instances. However, an updated list of Never Events published in 2015 included a wrong site surgery definition that added wrong tooth extractions to the list. According to a leading medical solicitor firm in the UK, wrong tooth extractions fall squarely into the NHS’ framework identifying preventable Never Events, categorized as a surgical intervention performed on the wrong site, such as a tooth. Because wrong tooth extractions are one of the most prevalent never events that involves a wrong site surgery, it is necessary to focus on ways to prevent them from happening.

Preventing Wrong Tooth Extraction

In the same year Never Events were initially identified, advocacy groups determined the need for strategies to thwart the serious harm caused to patients by Never Event incidents. To this end, a checklist modeled after the airline industry’s in-flight safety checklist became a requirement across hospital theatres in an effort to assist medical providers in preparing fully for surgical procedures. For dental hospitals, the checklist was meant to be used for major procedures such as tooth extraction in order to prevent wrong site surgery. Until recently, little information has been gathered or presented in the use of checklists for preventing wrong tooth extraction, or the extent to which checklists are used in tandem with other protocol to lower the risk of wrong tooth extraction.

In a recent self-assessment survey of 13 dental hospitals – 8 in England and 3 in Ireland – clinical directors were asked whether the a safety checklist was used, along with enquiries regarding Never Events in general, and recommendations for preventing wrong tooth extraction and other Never Events in the dental hospital setting. The survey revealed that checklists are used for all tooth extractions, and most dental hospitals utilise the checklist for outpatient procedures as well. Additionally, the majority of respondents agreed that reporting of wrong tooth extractions as a Never Event was an appropriate step toward accountability and transparency.

Overall, the use of safer surgical checklists are a benefit to patients who undergo dental surgeries, but they also help dental surgeons implement a high level of care as it relates to significant patient procedures. The ability to prevent medical missteps before they become a costly problem for patients and providers is a key component of improving the experience of patients while simultaneously reducing the occurrence of preventable incidents. While surgery checklists do not guarantee a stark reduction in medical mistakes, they do show some glimmer of hope that providers and the hospitals for which they work are aware of the need to protect patients’ health before a surgery is performed, and take the steps necessary to report errors or missteps should they ultimately take place. 

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