Siriwatana Kiti, Pongpanich Sathirakorn
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
BMC Oral Health. 2025 Mar 5;25(1):339. doi: 10.1186/s12903-025-05729-5.
Patient safety is critical in healthcare, and adverse events (AEs) in dental care require tailored reporting systems for accurate documentation and risk management. Generalized systems fail to address the unique needs of dentistry, necessitating a specialized approach. This study introduces the dental incident reporting system (DIRS), a user-centered framework designed to overcome the barriers in dental incident reporting.
This mixed-methods study was conducted in three phases. Phase 1 involved the development of a comprehensive classification system for dental AEs using 752 patient safety incidents reported over 5 years at the Dental Hospital, Faculty of Dentistry, Chulalongkorn University. Phase 2 involved the design and refinement of the DIRS, integrating features such as automated risk assessment and classification assistance, validated through heuristic evaluations. Phase 3 comprised usability testing with 16 end users using the system usability scale (SUS) and user acceptance test (UAT) to assess perceived effectiveness, usefulness, and satisfaction.
The classification system categorized dental-specific AEs, aligning with the hospital accreditation standards. The DIRS achieved a mean SUS score of 69.7, indicating above-average usability. The UAT showed high user ratings for effectiveness (mean, 3.15; SD, 0.49), usefulness (mean, 3.15; SD, 0.51), and satisfaction (mean, 3.38; SD, 0.48). Strong reliability (intraclass correlation coefficient, 0.91; 95% CI, 0.81-0.96) was demonstrated across the evaluations.
The DIRS addresses gaps in dental incident reporting by offering a user-friendly, standardized system. Its potential to enhance reporting accuracy and foster a culture of transparency highlights its significance for improving dental patient safety. Future efforts should focus on refining usability, expanding testing, and exploring scalability for broader adoption.
患者安全在医疗保健中至关重要，牙科护理中的不良事件（AE）需要量身定制的报告系统以进行准确记录和风险管理。通用系统无法满足牙科的独特需求，因此需要一种专门的方法。本研究引入了牙科事件报告系统（DIRS），这是一个以用户为中心的框架，旨在克服牙科事件报告中的障碍。
这项混合方法研究分三个阶段进行。第1阶段涉及使用朱拉隆功大学牙科学院牙科医院5年期间报告的752起患者安全事件，开发一个全面的牙科AE分类系统。第2阶段涉及DIRS的设计和完善，整合诸如自动风险评估和分类辅助等功能，并通过启发式评估进行验证。第3阶段包括对16名最终用户进行可用性测试，使用系统可用性量表（SUS）和用户接受度测试（UAT）来评估感知的有效性、有用性和满意度。
该分类系统对特定于牙科的AE进行了分类，符合医院认证标准。DIRS的平均SUS得分为69.7，表明可用性高于平均水平。UAT显示用户对有效性（平均3.15；标准差0.49）、有用性（平均3.15；标准差0.51）和满意度（平均3.38；标准差0.48）的评分很高。各项评估均显示出很强的可靠性（组内相关系数为0.91；95%置信区间为0.81 - 0.96）。
DIRS通过提供一个用户友好的标准化系统，解决了牙科事件报告中的差距。它提高报告准确性和培养透明度文化的潜力凸显了其对改善牙科患者安全的重要性。未来的工作应侧重于优化可用性、扩大测试范围以及探索可扩展性以实现更广泛的采用。
