Responding to Problems in Dental Practice with Transparency and Accountability

ABSTRACT

Background

Few situations are as stressful for dentists as when a harmful error has occurred in their care of a patient. Embarrassment, fear of litigation, and uncertainty about what to say and how the patient will react can complicate the response. While most dentists are committed to responding to problems with transparency and accountability, turning these principles into practice can be difficult.

Description

In this article, we discuss the lessons that dentistry can learn from the field of Medicine about being more transparent with patients about care problems and aligning this transparency with broader efforts to promote a culture of safety where openness and accountability drive learning and improvement. Transparency is recognized as a precondition to a culture of safety, and has many elements including open communication with patients and families, colleagues, and organizations about problems. While fear of litigation is a frequent concern when clinicians are contemplating being open with a patient about something that went wrong, robust evidence suggests that transparency, when approached in a disciplined and thoughtful manner, can actually reduce the chances of lawsuits. Communication and Resolution Programs are structured processes that can support dentists in their response to problems in care. The Dental Patient Safety Foundation is another important resource all dentists should know about and partner with to improve their practice. We provide practical suggestions that dentists can apply to their practice now to reduce the chances of harm events happening and to be better prepared to respond effectively when harm events occur.

KEYWORDS:

• Patient safety
• risk management
• ethics
• communication

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Supplementary Information

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19424396.2024.2324967

Additional information

Notes on contributors

Kerry R. Streiff

Kerry R. Streiff is a Clinical Instructor within the Department of Restorative Dentistry and the Director of the Ethics & Jurisprudence Curriculum within the Department of Oral Health Sciences at the University of Washington School of Dentistry. She also works as a general dentist at a private practice in Seattle.

Thomas H. Gallagher

Thomas H. Gallagher is a general internist who is Professor and Associate Chair of the Department of Medicine, as well as Professor in Department of Bioethics and Humanities, at the University of Washington.

Julie Morath

Julie Morath has more than three decades of experience as a healthcare executive, following her work as a registered and advanced practice nurse, specializing in psychiatry and mental health. She has held C-suite positions as Chief Nursing Officer and VP of Clinical Services, Chief Operating Officer and Chief Quality and Patient Safety Officer at major US health systems, including serving as President and CEO for the development of the Hospital Quality Institute of California.