Comparison of physicians' and dentists' incident reports in open data from the Japan Council for Quality Health Care: a mixed-method study.

Naomi Akiyama, Tomoya Akiyama, Hideaki Sato, Takeru Shiroiwa, Mitsuo Kishi
Author Information
  1. Naomi Akiyama: School of Nursing, Gifu University of Health Science, 2-92 Higashi Uzura, Gifu City, Gifu Prefecture, 500-8281, Japan. nakiyama888@gmail.com.
  2. Tomoya Akiyama: Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, 65 Tsurumai, Syowaku, Nagoya City, Aichi Prefecture, 466-8560, Japan.
  3. Hideaki Sato: Department of Oral and Maxillofacial Surgery, Asahikawa Medical University, 2-1-1 Midorigaoka Higashi, Asahikawa City, Hokkaido, 078-8510, Japan.
  4. Takeru Shiroiwa: Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health (NIPH), 2-3-6 Minami, Wako City, Saitama Prefecture, 351-0197, Japan.
  5. Mitsuo Kishi: School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka City, Iwate Prefecture, 020-8505, Japan.

Abstract

BACKGROUND: Patient safety is associated with patient outcomes. However, there is insufficient evidence of patient safety in the dental field. This study aimed to compare incidents reported by dentists and physicians, compare the type of errors made by them, and identify how dentists prevent dental errors.
METHODS: A mixed-methods study was conducted using open data from the Japan Council for Quality Health Care database. A total of 6071 incident reports submitted for the period 2016-2020 were analyzed; the number of dentists' incident reports was 144, and the number of physicians' incident reports was 5927.
RESULTS: The percentage of dental intern reporters was higher than that of medical intern reporters (dentists: n = 12, 8.3%; physicians: n = 180, 3.0%; p = 0.002). The percentage of reports by dentists was greater than that by physicians: wrong part of body treated (dentists: n = 26, 18.1%; physicians: n = 120, 2.0%; p < 0.001), leaving foreign matter in the body (dentists: n = 15, 10.4%; physicians: n = 182, 3.1%; p < 0.001), and accidental ingestion (dentists: n = 8, 5.6%; physicians: n = 8, 0.1%; p < 0.001), and aspiration of foreign body (dentists: n = 5, 3.4%; physicians: n = 33, 0.6%; p = 0.002). The percentage of each type of prevention method utilized was as follows: software 27.8% (n = 292), hardware (e.g., developing a new system) 2.1% (n = 22), environment (e.g., coordinating the activities of staff) 4.2% (n = 44), liveware (e.g., reviewing procedure, double checking, evaluating judgement calls made) 51.6% (n = 542), and liveware-liveware (e.g., developing adequate treatment plans, conducting appropriate postoperative evaluations, selecting appropriate equipment and adequately trained medical staff) 14.3% (n = 150).
CONCLUSION: Hardware and software and environment components accounted for a small percentage of the errors made, while the components of liveware and liveware-liveware errors were larger. Human error cannot be prevented by individual efforts alone; thus, a systematic and holistic approach needs to be developed by the medical community.

Keywords

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Grants

  1. 20K18889/Grants-in-Aid for Scientific Research

MeSH Term

Humans
Delivery of Health Care
Dentists
Japan
Patient Safety
Physicians
Incidental Findings
Medical Errors
Quality of Health Care

Word Cloud

Created with Highcharts 10.0.0physicians:reportsdentists:studyerrorsincidentpercentage1%egsafetydentaldentistsmademedical3bodyp < 00016%PatientpatientcomparetypeopendataJapanCouncilQualityHealthnumberdentists'physicians'internreporters3%0%p = 00022foreign4%n = 80softwaredevelopingenvironmentstafflivewareliveware-livewareappropriatecomponentsBACKGROUND:associatedoutcomesHoweverinsufficientevidencefieldaimedincidentsreportedphysiciansidentifypreventMETHODS:mixed-methodsconductedusingCaredatabasetotal6071submittedperiod2016-2020analyzed1445927RESULTS:highern = 128n = 180greaterwrongparttreatedn = 2618n = 120leavingmattern = 1510n = 182accidentalingestion5aspirationn = 5n = 33preventionmethodutilizedfollows:278%n = 292hardwarenewsystemn = 22coordinatingactivities42%n = 44reviewingproceduredoublecheckingevaluatingjudgementcalls51n = 542adequatetreatmentplansconductingpostoperativeevaluationsselectingequipmentadequatelytrained14n = 150CONCLUSION:HardwareaccountedsmalllargerHumanerrorpreventedindividualeffortsalonethussystematicholisticapproachneedsdevelopedcommunityComparisonCare:mixed-methodAdverseeventContentanalysisDentistryErrorIncidentreportInternMixed-methodsSHELLmodel

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