Patient perception of service quality to preanesthetic oral examination: a cross-sectional study using the SERVQUAL model

BACKGROUND

A phase-III interdisciplinary quality improvement program, the preanesthetic oral examination (PAOE), was implemented as a new program in an academic medical center to prevent perioperative dental injuries. This study was aimed at surveying the perceived service quality and satisfaction of patients who had undergone PAOE based on the SERVQUAL model.

METHODS

This cross-sectional survey was conducted at the Kaohsiung Medical University Hospital using convenience sampling. Patients referred for PAOE (PAOE group) and those who had voluntarily availed dental services (control group) were recruited. A modified SERVQUAL questionnaire was used to assess the perceived service quality and patient satisfaction with dental services. Cronbach's alpha for SERVQUAL was 0.861.

RESULTS

We enrolled 286 (68.8%) and 130 (31.2%) participants in the PAOE and control groups, respectively. The path analysis revealed that the PAOE group scored lower in dimensions of reliability (β = -0.074, P = 0.003), responsiveness (β = -0.148, P = 0.006), and empathy (β = -0.140, P = 0.011). Furthermore, reliability (β = 0.655, P < 0.001) and responsiveness (β = 0.147, P = 0.008) showed a direct effect on patient satisfaction. Overall, participants were highly satisfied with the dental services.

CONCLUSIONS

The PAOE group showed lower satisfaction and perceived quality of dental services compared to the control group. Although implementing an interdisciplinary program reduces the perceived service quality, its influence is limited. Employing an interdisciplinary teamwork is a win-win strategy encouraged to improve patient safety and reduce malpractice claims. Future suggestions should focus on establishing waiting times that are considered reasonable by patients. Patient-centered education related to the risk of perioperative dental injuries should be provided, and awareness of oral conditions for patient safety should be improved. Moreover, interprofessional education in continuous and undergraduate programs is necessary to improve professional quality.

Dental trauma in endoscopy: A systematic review and experience of a tertiary endoscopy centre

BACKGROUND

Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.

AIM

To determine frequency and effects of dental injury in endoscopy, we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.

METHODS

Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284% of procedures. Review of literature identified a similar rate of 0.33%.

RESULTS

Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected. Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay. Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.

CONCLUSION

Dental complications occur in approximately 1 in 300 of upper endoscopy cases. These are easily preventable by pre-endoscopy screening. Protocols to mitigate dental injury are also suggested.