PMID- 31821766
OWN - NLM
STAT- MEDLINE
DCOM- 20210111
LR  - 20210111
IS  - 2380-0852 (Electronic)
IS  - 2380-0844 (Print)
IS  - 2380-0844 (Linking)
VI  - 5
IP  - 3
DP  - 2020 Jul
TI  - Finding Dental Harm to Patients through Electronic Health Record-Based Triggers.
PG  - 271-277
LID - 10.1177/2380084419892550 [doi]
AB  - BACKGROUND: Patients may be inadvertently harmed while undergoing dental 
      treatments. To improve care, we must first determine the types and frequency of 
      harms that patients experience, but identifying cases of harm is not always 
      straightforward for dental practices. Mining data from electronic health records 
      is a promising means of efficiently detecting possible adverse events (AEs). 
      METHODS: We developed 7 electronic triggers (electronic health record based) to 
      flag patient charts that contain distinct events common to AEs. These electronic 
      charts were then manually reviewed to identify AEs. RESULTS: Of the 1,885 charts 
      reviewed, 16.2% contained an AE. The positive predictive value of the triggers 
      ranged from a high of 0.23 for the 2 best-performing triggers (failed implants 
      and postsurgical complications) to 0.09 for the lowest-performing triggers. The 
      most common types of AEs found were pain (27.5%), hard tissue (14.8%), soft 
      tissue (14.8%), and nerve injuries (13.3%). Most AEs were classified as temporary 
      harm (89.2%). Permanent harm was present in 9.6% of the AEs, and 1.2% required 
      transfer to an emergency room. CONCLUSION: By developing these triggers and a 
      process to identify harm, we can now start measuring AEs, which is the first step 
      to mitigating harm in the future. KNOWLEDGE TRANSFER STATEMENT: A retrospective 
      review of patients' health records is a useful approach for systematically 
      identifying and measuring harm. Rather than random chart reviews, electronic 
      health record-based dental trigger tools are an effective approach for practices 
      to identify patient harm. Measurement is one of the first steps in improving the 
      safety and quality of care delivered.
FAU - Walji, M F
AU  - Walji MF
AD  - School of Dentistry at Houston, University of Texas Health Science Center, 
      Houston, TX, USA.
FAU - Yansane, A
AU  - Yansane A
AD  - School of Dentistry, University of California, San Francisco, CA, USA.
FAU - Hebballi, N B
AU  - Hebballi NB
AD  - School of Dentistry at Houston, University of Texas Health Science Center, 
      Houston, TX, USA.
FAU - Ibarra-Noriega, A M
AU  - Ibarra-Noriega AM
AD  - School of Dentistry at Houston, University of Texas Health Science Center, 
      Houston, TX, USA.
FAU - Kookal, K K
AU  - Kookal KK
AD  - School of Dentistry at Houston, University of Texas Health Science Center, 
      Houston, TX, USA.
FAU - Tungare, S
AU  - Tungare S
AD  - School of Dentistry at Houston, University of Texas Health Science Center, 
      Houston, TX, USA.
FAU - Kent, K
AU  - Kent K
AD  - School of Dentistry, Oregon Health and Science University, Portland, OR, USA.
FAU - McPharlin, R
AU  - McPharlin R
AD  - School of Dentistry, Oregon Health and Science University, Portland, OR, USA.
FAU - Delattre, V
AU  - Delattre V
AD  - School of Dentistry at Houston, University of Texas Health Science Center, 
      Houston, TX, USA.
FAU - Obadan-Udoh, E
AU  - Obadan-Udoh E
AD  - School of Dentistry, University of California, San Francisco, CA, USA.
FAU - Tokede, O
AU  - Tokede O
AD  - Harvard School of Dental Medicine, Boston, MA, USA.
FAU - White, J
AU  - White J
AD  - School of Dentistry, University of California, San Francisco, CA, USA.
FAU - Kalenderian, E
AU  - Kalenderian E
AD  - School of Dentistry, University of California, San Francisco, CA, USA.
LA  - eng
GR  - R01 DE022628/DE/NIDCR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20191210
PL  - United States
TA  - JDR Clin Trans Res
JT  - JDR clinical and translational research
JID - 101684997
SB  - IM
MH  - *Electronic Health Records
MH  - Humans
MH  - *Patient Harm
MH  - Patient Safety
MH  - Precipitating Factors
MH  - Retrospective Studies
PMC - PMC7298886
OTO - NOTNLM
OT  - EHRs
OT  - adverse events
OT  - dentistry
OT  - informatics
OT  - patient safety
OT  - trigger tool
COIS- The authors declare no potential conflicts of interest with respect to the 
      authorship and/or publication of this article.
EDAT- 2019/12/11 06:00
MHDA- 2021/01/12 06:00
PMCR- 2020/12/10
CRDT- 2019/12/11 06:00
PHST- 2019/12/11 06:00 [pubmed]
PHST- 2021/01/12 06:00 [medline]
PHST- 2019/12/11 06:00 [entrez]
PHST- 2020/12/10 00:00 [pmc-release]
AID - 10.1177_2380084419892550 [pii]
AID - 10.1177/2380084419892550 [doi]
PST - ppublish
SO  - JDR Clin Trans Res. 2020 Jul;5(3):271-277. doi: 10.1177/2380084419892550. Epub 
      2019 Dec 10.