Developing A Patient Safety System For Dentistry

描述(由申请人提供)：目前对牙科患者安全问题的类型或频率知之甚少。尽管牙医和内科医生一样，经常在复杂的环境中进行技术性很强的程序，团队合作，并使用多种设备和工具，但患者安全革命绕过了牙科。只有最严重的牙科护理不良事件被记录在案。为了减少对患者的伤害，提高护理质量，迫切需要定义和识别牙科环境中的不良事件。作为一个长期目标，重要的是要了解牙科不良事件的原因，并制定干预措施，将其发生率降至最低。该应用程序的目标是开发必要的工具来记录牙科不良事件，生成有助于组织和链接不良事件的分类方案和存储库，并允许5个牙科组织开始系统地收集和分析不良事件。关于患者安全做法和不良事件的证据在牙科领域严重缺乏。这项提案将使牙科从对不良事件一无所知的状态转变为实现患者安全倡议的第一个要素：确定对牙科患者安全的威胁。开发必要的工具来捕捉牙科不良事件，并建立一个分类方案来组织它们，这些都是对牙科护理和研究的全新贡献。这将使牙科研究进入一个新的领域，对患者安全、质量改进和卫生经济学具有广泛和直接的影响。将开发和验证患者安全工具包(PST)，以记录牙科环境中的不良事件。该工具包将包括1)图表审查工具，(2)新的牙科不良事件严重程度排名，以及(3)新的牙科不良事件分类方案。下一步，将建立一个数据存储库，允许分析不良事件。最后，PST将被部署到5家参与的牙科机构，每个地点将向数据库提交其PST分析的结果。这项工作将产生第一个牙科患者安全储存库和报告系统，以及第一个对牙科环境中不良事件发生的经验测量。这五个网站在一年内查看了超过10万名患者，从而创建了一组丰富的数据，以提高牙齿护理的质量。此外，该项目将极大地提高人们对牙科患者安全重要性的认识。

DESCRIPTION (provided by applicant): There is currently little to no understanding about type or frequency of patient safety issues in dentistry. Although dentists, like physicians, routinely perform highly technical procedures in complex environments, work in teams, and use a multitude of devices and tools, the patient safety revolution has bypassed dentistry. Only the grossest of dental care adverse events have been documented. In order to reduce patient harm, and improve the quality of care delivered, there is a critical need to define and identify adverse events in dental settings. As a long term goal, it is important to understand the causes of dental adverse events and develop interventions to minimize their occurrence. The objective of this application is to develop the tools necessary to document dental adverse events, generate a classification scheme and repository that can help organize and link adverse events, and allow 5 dental organizations to begin to systematically collect and analyze adverse events. Evidence about patient safety practices and adverse events is sorely lacking in dentistry. This proposal will take dentistry from a state of adverse event ignorance to achieving the first element of a Patient Safety Initiative: determining threats to dental patient safety. Developing the tools necessary to capture adverse events in dentistry and building a classification scheme to organize them are entirely novel contributions to dental care and research. This will enable a new field of dental research that has broad and direct implications on patient safety, quality improvement, and health economics. A Patient Safety Toolkit (PST) will be developed and validated for the documentation of adverse events in the dental setting. This toolkit will consist of 1) a chart review tool, (2) a novel severity ranking of dental adverse events, and (3) a novel, dental adverse events classification scheme. Next, a data repository will be build, allowing for the analysis of adverse events. Lastly, the PST will be deployed to the 5 participating dental institutions and each site will submit the results of their PST analyses to the data repository. This work will result in the first dental patient safety repository and reporting system, as well a the first empirical measurements of the occurrence of adverse events in the dental setting. Over 100,000 patients are seen in one year by the five sites, thus creating a rich set of data to improve the quality of dental care. Additionally, this project will greatly raise awareness of the importance of patient safety in dentistry.