Engaging Patients for Patient Safety: Dentists can ‘elevate the voice of patients’

This year's theme for the World Health Organization's World Patient Safety Day (17 September) is Engaging Patients For Patient Safety, in recognition of the crucial role patients, families and caregivers play in the safety of health care. Active patient involvement, both in their own personal care as well as at a strategic organisational level, is vital to help improve healthcare provision, and the RCSEd is delighted to support this year's WPSD theme. 

The RCSEd Patient Safety Group have produced a number of blogs as part of a campaign to mark World Patient Safety Day. In this blog, Claire Morgan, Consultant in Restorative Dentistry, Dental Council Member and Dental Council representative on the College’s Patient Safety Group, highlights how dentists can elevate the voice of patients. 

Dentists can ‘elevate the voice of patients’ at each stage in their care pathway by encouraging them to speak up and take an active part in their own safety. For safety we must be sure to treat the correct patient at the correct time with the correct procedure checking in with the patient.

PRE-OPERATIVE

1. Medical History - We must ensure our patients understand the importance of informing us of any changes in their medical history at each visit. For example: pregnancy, medications, allergies, new diagnoses including cardiac issues that could impact on their safety. Changes must checked with the patient and updated and recorded in dental records at each visit.
2. Risk Screening - We should inform patients during our screening for risk factors and signs of oral disease, and when to seek help. This includes oral cancer where information and posters in our waiting rooms can help to save lives and keep our patients safer through early diagnosis to improve outcomes.
3. Dental Anxiety - It is important we ask our patients about dental anxiety. Patients must be informed of alternatives and treated with appropriate pain management.  They should be able to signal if they wish to stop treatment, this can reassure patients and prevent sudden movement. Alternative pain management should be discussed with our patients to allow them to make the right choice to ensure they are safe when we are treating them.

OPERATIVE

1. Consent - Involving patients in their care with shared decision making (SDM) with safe choices given at the outset is essential. In the consent process we must explain risks and benefits of all treatment options. When explaining risks we should discuss the safety of all potential procedures and in not having treatment. Consent is an ongoing process and we must record this in the patients record at each visit. Part of the consent process is also:
2. Ensuring our patients understand -Not understanding information may be due us as dentists using dental jargon and not plain English when conveying information to our patients. A lack of understanding can be exacerbated by a language difference or a learning disability. We should also remember that not all our patients can read English therefore easy read and translations must be available. It is our role to encourage patients to let us know if they don’t understand and for us to check they do understand.
3. Surgical Check Lists - It is essential before carrying out any invasive procedure that we re-check all patient details and review records. During this process patients should feel involved and be aware of which tooth we plan to operate on and be made to feel comfortable to speak up if they have doubts.

POST-OPERATIVE

1. After Care - Our patients and carers must understand the importance of their role in aftercare post-operatively. Examples could be following use of local anaesthetic particularly in children and management of bleeding from extractions sockets.
2. Post Operative Medication - If pain relief or antibiotics are prescribed it is important that our patients are fully aware of maximum doses, how to take their medication, allergies and potential side effects.
3. Follow Up – We need discuss with our patients what follow up is required and why we are recommending this. They must be given responsibility and guidance to take initiative if they do not receive a recall in the advised time scale. This will include all oral health reviews.