By Theresa Pablos, DrBicuspid.com associate editor

June 14, 2019 -- What qualities make for a safety-focused dental practice? Nearly 400 hygienists shared their thoughts in a recently published study. Both the number of hours worked and number of patients seen per day had a big impact on perceived patient safety.

Hygienists who worked less than 41 hours per week and saw fewer than eight patients per day were more likely to report their practices had a culture focused on patient safety, researchers found. The findings, which were published in BMC Health Services Research (May 10, 2019), emphasize the importance of workplace policies for a safety-focused practice.

"To establish high-quality care and patient safety system, practical policies must be enacted," wrote the authors, led by Eun-Mi Choi from the department of dental hygiene at Yonsei University in Seoul, South Korea. "In particular, assurance in the quality of work environment, such as sufficient staffing, appropriate work hours, and enough rest must first be realized before patient safety culture can easily be formed."

The safety-focused practice

The practice of dentistry includes many potentially hazardous tools and materials, and patient safety is one of the top concerns for dental professionals. While research on working conditions and patient safety is relatively common in medical and hospital-based settings, this type of research is limited within dentistry. Therefore, the researchers sought to study the relationship between workplace environment and patient safety for dental practices in South Korea.

“Lack of safety procedures is simply not an option or up for opinion.”
— Corinne Jameson-Kuehl, RDH

The researchers surveyed 377 dental hygienists about the patient safety culture at their workplaces. This included questions on the openness of communication about patient safety, frequency of reported incidences, systems and procedures for patient safety, hygienist workload, and concerns about errors.

Only about half of respondents practiced at a workplace with a patient-safety culture, the researchers found. Hygienists were significantly more likely to report a culture of patient safety if they worked 40 hours or less per week and saw eight or fewer patients per day. The researchers hypothesized long hours could worsen hygienist performance.

"Regarding the number of hours worked per week, all of the components of patient safety culture, except systems and procedures for patient safety, were higher among those who worked less than 40 hours per week," the authors wrote. "The negative influence of long work hours previously found on job performance might be a somewhat obvious link."

In addition, facilities with seven or fewer dental chairs were more likely to have a culture of patient safety than larger organizations. The same was true for hygienists who worked at dental clinics, as opposed to those employed at hospitals.

"This finding supports previous results that smaller medical facilities have stronger patient safety cultures than larger medical facilities," the authors wrote. "Smaller facilities are more likely than larger ones to enjoy shared cultures, homogeneous values among workers, and influential leadership."

Protocols over patient numbers

The study had a number of shortcomings, including that the dental hygienists surveyed lived in metropolitan regions of South Korea. As a result, the findings cannot be generalized to workplaces in rural areas or those in other counties.

Nevertheless, creating a culture of patient safety is something that transcends borders. Practice management expert Corinne Jameson-Kuehl, RDH, noted that establishing protocols is the key to patient safety, regardless of the number of patients a practice sees per day. She also emphasized practice leadership must serve as an example.

"The safest culture for a dental practice is one where the entire team practices the same Occupational Safety and Health Administration standards and values them," she told DrBicuspid.com. "Lack of safety procedures is simply not an option or up for opinion."


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