||Type/Method of study
Suggestions to improve patient safety/culture (bullet, in bold)
|Kiersma et al. (2011) 
||A systematic review (Patient safety instruction in health professional curriculum)
||1. 1966-2010: No articles found on patient safety initiative in dentistry
2. Patient safety training was added to the medical curriculum in the form of lectures, case-based exercises, active and simulation exercises, along with medical audits.
3. Self-assessment survey was used to determine student perception of patient safety after training them. The assessments from various literature review show improvement in knowledge, attitude, and skill related to patient safety
• Recommend curriculum change to include patient safety. The above assessment showed improvement in patient safety, and hence the authors recommended curriculum change to include patient safety.
|Pemberton et al. 2014 
||16 dental institutes under NHS
||Dec 2009 - Sept 2013
||Measuring patient safety through the development of a dental clinical effectiveness dashboard for institutions
||The dashboard contained:
1. Measures of harm evaluated by the number of patient falls, medication errors, and adverse events.
2. Measures of reliability of safety processes, such as hand hygiene, dental audits, clinical training, correct site surgery, patient identification, progress note entries, completed consent form, BLS, and ACLS training with the annual report.
3. Clinical effectiveness. All these were monitored over three years to improve patient safety. The dashboard had performance indicators on patient safety. When the indicator was red, it showed a fall in the set benchmark, and hence initiatives were taken to work on the identified factor. This way, in three years, almost all factors were showing a green indicator, indicating an acceptable benchmark for all patient safety factors.
• Recommend consistent training in patient safety protocols to increase patient safety compliance.
|Thierer et al. (2017) 
||1 dental school
||A retrospective review of Electronic documentation in US dental school by students
||1. On the evaluation of progress notes, poorly documented records were identified, and the students who did poor documentation were traced.
2. The students who did poor documentation and their supervising faculty were given corrective training in documentation
• Recommend repeated monitoring followed by corrective training for proper documentation improved compliance.
|Osegueda- Espinosa et al. (2017) 
||34 Dental school graduates
||2013 - 2014
||Self-administered questionnaire survey
||During undergraduate dental clinical training, dental students committed errors that placed patients at risks, such as pulp exposure, sharp instrument injury, burns, wrong tooth extraction, injection of sodium hypochlorite instead of local anesthesia, breakage of needles during anesthesia, and accidental swallowing of a restoration
• Recommend more training, orientation, and continuing education in patient safety protocols.
|Bedout et al. (2018) 
||22 residents in specialty programs, 21 specialist faculty members, and 24 general practice faculty members and others
||Dental residents were given a questionnaire with ten clinical emergency cases and asked to identify the diagnosis and indicated intervention.
Several responses had varying degrees of incorrect diagnoses and management across all groups. In the case of hyperventilation, 59% of responses had an incorrect diagnosis in the case of cardiac arrest, 36% had incorrect diagnoses.
• Repetitive training to be done for better preparedness in the diagnosis and management of medical emergencies in a dental setting.
|Ramoni et al. 2014 
||3 dental schools with
328 participants; dental students:48%, Dental hygienists: 1%
Faculty: 23% and staff: 25%
|2010 - 2011
||Medical office survey on patient safety culture (AHRQ)
||1. Six dimensions were evaluated: Communication Openness, Communications about Error, Organizational Learning, Overall Perceptions of Patient Safety and Quality, Owner/Managing Partner/Leadership Support for Patient Safety, and Teamwork.
2. Compared Data with an average of medical fields from MOSOPS
3. Patient follow up for dental fields was only 36%, but for medical fields, the patient follow up was 82%
• Recommendation: A clear need is demonstrated to improve dental patient safety culture in dental institutions.
|Al Sweleh et al. 2017 
||1 Dental school
||Cross-sectional study based questionnaire (Modified AHRQ)
||Twelve dimensions were evaluated: Teamwork, manager expectations, organizational learning, management support, the overall perception of patient safety, communication, adverse event reporting, handoffs, blame culture, openness, and staffing.
Perception of patient safety culture varied among students to practitioners.
• Improvement in communication openness, staffing, and fear of blame is required in dental clinics.
|Al- Surimi et al. 2018 
||2 Dental schools
Only female dental students: 133 and dental hygienists: 88
|Nov 2016- Jan 2017
||A cross-sectional study based on a self-administrative survey
||Student perceptions on teamwork, safety climate, job satisfaction, stress recognition, management support, and working conditions were evaluated. The overall average outcome indicated 54.4% for teamwork, 51.4% for safety climate, 64.5% for job satisfaction, 56.2% for stress recognition, 50.7% for management support, and 55.3% for working condition.
• Patient safety principles are to be included in national rules, regulations, and guidelines. Increased awareness and training students will improve the patient safety culture.
|Ahsan et al. 2019 
||Dental schools: 2 clinics of dental schools
Dental staff and assistants including residents: 149
|March to June 2016
||A cross-sectional study based on Patient safety culture hospital Questionnaire.
||Teamwork, adverse event reporting, supervisor appreciation when a job was done well, and importance to patient safety was evaluated.
Variation in the perception of patient safety culture in the same organization and between organizations.
• Recommend that respective organizations give priority to patient safety
|Yansane et al. 2020 
||3 US Dental schools; 656 participants, including students, staff, and assistants
||Cross-sectional study (Medical office survey on patient safety culture)
||Ten dimensions were evaluated: overall perceptions of patient safety and quality, organizational learning, teamwork, staff training, work pressure, communication openness, communications about the error, owner/managing partner/leadership support for patient safety, patient follow-up and office processes.
The analyzed dental data were compared with previously published medical data, and it was found that medical schools outperformed dental schools in overall quality dimensions in 2012, but in 2016 after training, the gap in performance between medical and dental fields had narrowed.
The survey was first conducted in 3 dental schools in 2012. After focused improvement training, the survey was repeated in the same dental schools in 2016. The second survey showed an improvement in performance from 2012 to 2016.
• Recommend focused training of all dental providers on patient safety culture.