Developing and evaluating a dental incident reporting system: a user-centered approach to risk management

Patient safety is critical in healthcare, and adverse events (AEs) in dental care require tailored reporting systems for accurate documentation and risk management. Generalized systems fail to address the unique needs of dentistry, necessitating a specialized approach. This study introduces the dental incident reporting system (DIRS), a user-centered framework designed to overcome the barriers in dental incident reporting.

This mixed-methods study was conducted in three phases. Phase 1 involved the development of a comprehensive classification system for dental AEs using 752 patient safety incidents reported over 5 years at the Dental Hospital, Faculty of Dentistry, Chulalongkorn University. Phase 2 involved the design and refinement of the DIRS, integrating features such as automated risk assessment and classification assistance, validated through heuristic evaluations. Phase 3 comprised usability testing with 16 end users using the system usability scale (SUS) and user acceptance test (UAT) to assess perceived effectiveness, usefulness, and satisfaction.

The classification system categorized dental-specific AEs, aligning with the hospital accreditation standards. The DIRS achieved a mean SUS score of 69.7, indicating above-average usability. The UAT showed high user ratings for effectiveness (mean, 3.15; SD, 0.49), usefulness (mean, 3.15; SD, 0.51), and satisfaction (mean, 3.38; SD, 0.48). Strong reliability (intraclass correlation coefficient, 0.91; 95% CI, 0.81-0.96) was demonstrated across the evaluations.

The DIRS addresses gaps in dental incident reporting by offering a user-friendly, standardized system. Its potential to enhance reporting accuracy and foster a culture of transparency highlights its significance for improving dental patient safety. Future efforts should focus on refining usability, expanding testing, and exploring scalability for broader adoption.