Patient Harm From Orthodontic Care (Part III): The Care Provider Perspective and the Second Victim Phenomenon.

Abstract

Background: Understanding the psychological and professional consequences of patient harm events is crucial for improving clinical practice and support systems.

Aim: (1) To investigate the prevalence of self-reported patient harm events involving orthodontic professionals, (2) to assess the psychological, physical, and professional impact of these events, and (3) to identify aspects of importance to mitigate the psychological and physical impact among orthodontic care providers involved in patient harm events.

Materials & methods: An online questionnaire-based survey was conducted among orthodontic care providers, including orthodontists, dentists, hygienists, and dental assistants during two orthodontic conferences in Denmark. The questionnaire assessed respondents' experience with patient harm events, types of harm, the psychological and physical impact of being involved, and their working environment.

Results: A total of 297 participants completed the survey, in which 45.9% (n = 135) reported involvement in a patient harm event and 20.8% (n = 61) experienced an event within the past year. Following a harmful event, significant psychological distress was reported by 49.2% (n = 87) of professionals, while 21.5% (n = 38) experienced physical symptoms and 8.8% (n = 16) considered leaving their job. A fear of causing harm was also evident, with 32.4% (n = 95) participants experiencing high to very high levels of psychological stress. Orthodontists reported greater stress related to the risk of causing harm compared to other orthodontic team members (p = 0.001). Orthodontists involved in a patient harm event also reported greater psychological (p = 0.002) and physical impact (p = 0.001) than other clinical staff members. No significant differences were found based on age, gender or years of clinical experience. Respondents most frequently identified structured organizational support, supportive leadership, and peer support as key measures to mitigate the impact of patient harm events.

Conclusion: Patient harm events may affect orthodontists and staff and potentially cause significant psychological and physical impact, emphasizing the need for structured support and peer programmes to enhance provider well-being and patient safety.