Survey Study among Dentist in Bulgaria to Develop a Model for Risk Management in Dental Practice.

Background: Quality control and risk management in the field of dental services is an important part of improving patient safety as well as that of the dentists. The introduction of a risk management model would simplify and facilitate this process.

Aim: The aim of the study is to gather information about the structurе and organization of work processes in Bulgarian dental practices, which will serve as a basis for building a risk management model. . A survey was conducted among randomly selected dental associations in Bulgaria-Plovdiv, Sofia, Varna, and Burgas through an anonymized questionnaire, containing 30 questions. The respondents meet the main criteria, namely, to be dentists and to practice in Bulgaria. The study includes demographic data, information on the attitude of Bulgarian dentists towards issues related to quality management, and safety and risk in respect to dental practice. The results have been processed and analyzed through descriptive and graphical analysis using the statistical program SPSS 20.0.

Results: A total of 103 Bulgarian dentists took part in the study, out of which 25.24% ± 4.28% have acquired a specialty. Women are 52.43% ± 4.92%, and men -47.57% ± 4.92%. The largest is the relative share of the respondents in the age range of 25-35 years -63.10% ± 4.75% and with work experience of 6-15 years -52.43% ± 4.92%. Most of the respondents do not define in writing the main tasks and activities -52.43% ± 4.92%, and do not use checklists in their practice -54.73%. The majority of the respondents do not hold regular meetings with their teams -50.49% ± 4.93%, as well as they do not conduct surveys among their patients -68.93% ± 4.56%. The majority of the respondents -41.75% ± 4.86% are guided by their personal judgment in respect to whether the written information provided to patients is comprehensible and accessible. The majority of dentists -45.63% ± 4.91% take informed consent only for expensive procedures in written and oral form -53.40% ± 4.92%. Out of all the respondents, 75.73% ± 4.22% have not analyzed the risk of slipping in their practices for the last two years.

Conclusion: There is a lack of written definition of the main tasks and processes, as well as no use of checklists in the practices of most of the interviewed dentists. Meetings with teams are held irregularly. There is a lack of surveys among patients, as well as no objective feedback from patients regarding the comprehensibility of the information materials provided. Informed consent is obtained from patients mainly in written and oral form and only for costly manipulations. In the practices of most of the interviewed dentists, there has been no assessment of the risk of slipping and falling for the last 2 years.