Classification of Dental Adverse Events Using Iterative Qualitative Analysis

Background: Effective incident reporting systems (IRS) are essential in dentistry for identifying and preventing adverse events (AEs), with standardized classifications ensuring consistent incident categorization. This study aimed to develop and validate a classification system for dental patient safety incidents based on a 5-year case study at the Dental Hospital at Chulalongkorn University, Thailand. Methods: An iterative qualitative approach was used. A literature review explored existing accreditation standards and AE classification systems. Incident reports from 2018–2022 informed a draft classification system aligned with Thailand’s National Reporting and Learning System and accreditation standards. Reports from 2023 were used for validation. An expert panel assessed the system using a 7-point Likert scale. Results: A total of 1,618 incident reports were analyzed, with 752 classified as safety incidents in patients with dental problems. The finalized system consisted of 28 main categories and multiple subcategories. The top three reported patient safety incidents were medical record errors, accidental damage, and post-operative complications. Expert evaluations demonstrated strong consensus on the system's relevance and comprehensiveness. Conclusions: The developed comprehensive classification system is adaptable across various dental care settings, providing a framework for standardized reporting, data analysis, and improved risk management. This system improves dental care quality by making incident reporting more accurate and consistent. More research is needed to see its long-term impact on patient safety and how it fits into a full reporting system. Keywords: Dental patient safety, Dental adverse events, Incident reporting system, Dental risk management, Classification system, Dental quality improvement