The evolution of patient safety procedures in an oral surgery department.

NHS Improvement highlights the importance of providing consistently safe care within the NHS. For dental professionals, this particularly concerns the reporting and avoidance of never events such as wrong tooth extraction and other serious incidents. Within the authors' unit, a number of infrequent never events and the national drive to introduce safety frameworks (NatSSIPs) has led to a reassessment of our safety procedures. In this paper, as part of our safety improvements, we discuss the chronological changes made in safety procedures following untoward events. Subsequently, we introduced a surgical safety briefing (the 'huddle') within the outpatient setting where we undertake invasive oral surgery procedures under local anaesthetic including intravenous sedation. By supplementing the 'huddle' with human factors training for all clinical staff there have been no further never events or serious incidents in the last two and a half years.

Single view radiographic screening of midfacial trauma.

Sidebottom et al. have previously shown that one occipitomental 15 degrees view (OM15) is sufficient for screening the majority of cases of midfacial injury. This audit study investigates the effect of introducing a one-view OM15 screening policy into the Accident & Emergency department (A&E) of a district general hospital. Six hundred and twenty-one patients had midfacial radiographic screening over a one-year period. Six hundred and one patients had all notes and radiographs available. Only eight required further views to confirm diagnosis. Thirty-eight fractures were diagnosed with two insignificant fractures of the antral wall missed. The cost saving was Pound Sterling 2082.50 for films alone. Eighty hours of radiographer time were additionally saved. There was no increase in referrals to the maxillofacial team. Single-view radiographic screening for midfacial injuries in A&E attenders is both safe and economical. Extrapolated to the UK population as a whole this would amount to a cost saving to the National Health Service of Pound Sterling 500000.