Estudio de la cultura de seguridad en el paciente en la docencia del grado en odontología de la Universidad Complutense de Madrid

La Seguridad del Paciente, es un área transversal que utiliza conocimientos bien establecidos en otras áreas, junto con una organización de dichos conocimientos y una sistemática propias. La Seguridad del Paciente se ocupa de la prevención de los daños evitables padecidos por los pacientes a consecuencia de la asistencia sanitaria, y de la detección precoz y limitación de los daños no evitables. Así, la Seguridad del Paciente estudia las características de los sistemas sanitarios en cuanto a la determinación de los riesgos latentes, como características del sistema que pueden permitir o incluso fomentar la producción de un evento asistencial adverso. Las peculiaridades metodológicas de la Seguridad del Paciente se refieren en especial a los sistemas de notificación, clasificación y estudio de los eventos adversos, y la propuesta e implantación de medidas correctoras o de mejora. El nacimiento de la Seguridad del paciente como "área científica" es relativamente reciente. Se inició con los trabajo de Leape y cols. de la Harvard Medical School (EEUU), que estimaron que de todos los eventos adversos registrados, dos tercios podrían haberse prevenido. Pero el impulso definitivo para la Seguridad del Paciente como "área científica" fue la publicación del estudio "To err is human" del Institute of Medicine (EEUU). Este estudio estimaba el número de fallecimientos provocados por errores en la asistencia hospitalaria en los EEUU, entre los 44.000 y los 98.000 al año. La cifra era de tal importancia que, aunque su metodología ha sido discutida, reveló a la sociedad, a los gestores sanitarios, y a los poderes políticos, la importancia social y económica de prevenir en la medida de lo posible los errores asistenciales. En el ámbito odontológico, las iniciativas no han sido tan numerosas ni tan estructuradas, pese a que la seguridad de los pacientes también ha sido una de las preocupaciones intrínsecas de la práctica odontológica desde sus inicios..

Professional liability in oral surgery : legal and medical study of 63 court sentences

Objectives: Dentistry, like all other health care professions, has in recent years been subjected to an increase in legal pressure by patients. Nevertheless, there are areas of activity in dentistry in which, whether because of their frequency or due to the importance of the damage and sequelae claimed, this legal pressure is greater. Amongst these areas of activity is that of oral surgery. Study design: To be meticulously analyzed in this report are 63 sentences issued by courts of second instance or higher levels regarding lawsuits involving oral surgery. The data collection file includes 13 variables. The descriptive and comparative statistical study by cross-referencing certain variables provides us with a clear and accurate picture of the lawsuit profile. Results and conclusions: Implantological surgery was the practice subject to the most claims due to surgery (55.6 percent: 35 sentences), and it drew our attention that in 71.4% of all cases (45 sentences) there was a ruling against the professional. The most frequent range of damage payments was between ?18,001 and ?60,000 (40.9%: 18 sentences), the highest amount having been ?24,000, an important factor to take into account when contracting professional civil liability insurance. © Medicina Oral S. L

Observatorio Complutense para la Seguridad Clínica Odontológica

Depto. de Medicina Legal, Psiquiatría y PatologíaFac. de MedicinaFALSEsubmitte

Analysis of 415 adverse events in dental practice in Spain from 2000 to 2010

Introduction: The effort to increase patient safety has become one of the main focal points of all health care profes - sions, despite the fact that, in the field of dentistry, initiatives have come late and been less ambitious. The main objective of patient safety is to avoid preventable adverse events to the greatest extent possible and to limit the negative consequences of those which are unpreventable. Therefore, it is essential to ascertain what adverse events occur in each dental care activity in order to study them in-depth and propose measures for prevention. Objectives: To ascertain the characteristics of the adverse events which originate from dental care, to classify them in accordance with type and origin, to determine their causes and consequences, and to detect the factors which facilitated their occurrence. Material and Methods: This study includes the general data from the series of adverse dental vents of the Spanish Observatory for Dental Patient Safety (OESPO) after the study and analysis of 4,149 legal claims (both in and out of court) based on dental malpractice from the years of 2000 to 2010 in Spain. Results: Implant treatments, endodontics and oral surgery display the highest frequencies of adverse events in this series (25.5%, 20.7% and 20.4% respectively). Likewise, according to the results, up to 44.3% of the adverse events which took place were due to predictable and preventable errors and complications. Conclusions: A very significant percentage were due to foreseeable and preventable errors and complications that should not have occurred

Professional Liability in Oral Surgery e526 Journal section: Oral Surgery Publication Types

Abstract Objectives: Dentistry, like all other health care professions, has in recent years been subjected to an increase in legal pressure by patients. Nevertheless, there are areas of activity in dentistry in which, whether because of their frequency or due to the importance of the damage and sequelae claimed, this legal pressure is greater. Amongst these areas of activity is that of oral surgery. Study design: To be meticulously analyzed in this report are 63 sentences issued by courts of second instance or higher levels regarding lawsuits involving oral surgery. The data collection file includes 13 variables. The descriptive and comparative statistical study by cross-referencing certain variables provides us with a clear and accurate picture of the lawsuit profile. Results and conclusions: Implantological surgery was the practice subject to the most claims due to surgery (55.6 percent: 35 sentences), and it drew our attention that in 71.4% of all cases (45 sentences) there was a ruling against the professional. The most frequent range of damage payments was between €18,001 and €60,000 (40.9%: 18 sentences), the highest amount having been €24,000, an important factor to take into account when contracting professional civil liability insurance

Patient safety in dentistry : dental care risk management plan

Objectives: Although the safety of patients has been one of the inherent concerns of dental practice, but because the proposals made in the field of dentistry are few and improperly structured, this paper constitutes an attempt to present a proposal titled "Plan for Dental Health Care Risk Management," promoted by the General Council of Dentists of Spain, including a description of the proposed work methodology. Design: The "risk management plan" proposed in this paper is based on applying the basic concepts dealt with in patient safety to the field of dentistry, due to the fact that the available bibliography contains no specific "health care risk management plan" for dentistry specifically. Results and conclusions: In order to implement health care risk management in the field of dental care provided at any level throughout Spain, a seven-step plan which covers the main objectives in Patient Safety is provided. © Medicina Oral S. L

Proposal of a "Checklist" for endodontic treatment

Objectives: On the basis of the 'Surgical Checklist' proposed by the WHO, we propose a new Checklist model adapted to the procedures of endodontic treatment. Study Design: The proposed document contains 21 items which are broken down into two groups: those which must be verified before beginning the treatment, and those which must be verified after completing it, but before the patient leaves the dentist's office. Results: The Checklist is an easy-to-use tool that requires little time but provides, order, logic and systematization by taking into account certain basic concepts to increase patient safety. Discussion: We believe that the result is a Checklist that is easy to complete and which ensure the fulfillment of the key points on patient safety in the field of endodontics

The clinical safety of disabled patients: proposal for a methodology for analysis of health care risks and specific measures for improvement

The clinical risks associated with health care have been a known factor since ancient times, and their prevention has constituted one of the foundations of health care. However, concern for the risks involved in health care treatments has risen very significantly in recent years, becoming a modern current of concern for clinical health care risks which is referred to by the name of "patient safety" in the scientific literature. Unfortunately, there are no studies on patient safety in dental practice or case studies of adverse events in this practice. In addition to the lack of studies on adverse events in regular dental practice, there are even fewer references to treatment for disabled patients. In this article, we provide a "proposal for analysis" of the clinical risks associated with treating disabled patients, which will make it possible to evaluate the health care risks associated with the treatment of patients who have a specific disability, at one determined moment and in one specific environment