The Culture of Safety in Oral and Maxilofacial Surgery

Previously in a post over at, I discussed how the Journal of Oral and Maxillofacial Surgery is introducing a new perspectives section which

“…will offer essays written on topics of interest to our specialty, including health policy, clinical controversies, and education and research matters, as examples.”

On of the first perspectives section is written by Suzanne Morse Buhrow and titled “Promoting a Culture of Safety in Oral and Maxillofacial Surgery: The Time Is Now!” in the February 2014 Journal of Oral and Maxilofacial Surgery, pp. 239-240. The article opens by discussing the origins of the patient safety movement in the 1980s after the Institute of Medicine said 98,000 patients will die and 1.5 million will be injured every year from preventable medical errors in the United States. The article mentions how the National Practitioner Data Bank in the U.S. shows over 10% of all malpractice payments are from dental procedures.

The article mentions a study from 2010 which said only 43% of oral and maxillofacial surgeons have reported a wrong site tooth extraction, mentioned as a leading preventable error. Further the article says only 60% of physicians share and report adverse events. The article applauds the American Association of Oral and Maxillofacial Surgeons (AAOMS) for promoting a culture of safety. The article then outlines some steps to help continuing to promote a culture of safety in oral and maxillofacial surgery

  1. Creating a sense of urgency for patient safety
  2. Providing training on the science of safety to physicians and their staff
  3. Using validated assessment tools for patient safety
  4. Creating a federally recognized patient safety organization for oral and maxillofacial surgery.

The author mentions that insuring a culture of patient safety in oral and maxillofacial surgery is vital to restoring the public confidence in surgeons who are providing the care. Further it is important to move away from a name and blame culture to a sharing and learning from errors culture.

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