Table 1.

Basic definitions related to patient safety

Patient safety	The reduction (or elimination as far as possible) of damage to patients resulting from health care processes or accidents associated with them
Health risk management	Trying to identify, evaluate and treat problems that can cause harm to patients, lead to malpractice claims and cause unnecessary economic losses to health care providers
Adverse event	Unexpected result of medical treatment that causes the prolongation of treatment, any type of morbidity, mortality or any other damage to which the patient should not have been exposed
	This is a broad concept that includes errors, accidents, delays in care, negligence, complications associated with treatment, etc. It does not include the symptoms of the patient’s presenting illness. The definition of ‘adverse event’ as it is commonly used across the health care sector is difficult to apply to dental care. Adverse events may be avoidable or unavoidable. An example of a preventable adverse event is the prescription of a drug to which a patient is allergic as a result of failing to consult clinical records. An example of a non-preventable adverse event is an adverse reaction to the administration of a local anaesthetic in a patient without clinical pathology or allergic history. However, the fact that an adverse event is not preventable does not mean that we should be unprepared to act quickly and appropriately if it occurs
Error	Mistake by omission or commission in health care practice, whether in planning (error of planning) or execution (error of execution). The error may or may not cause the occurrence of an adverse event. Although by definition all errors should be avoidable, the repetition of similar acts, in combination with organisational failures, make this task particularly difficult
Incident (‘near miss’)	An event that almost causes harm to a patient and that is avoided by luck or by an act at the last moment. An example of a near miss is the administration of a penicillin-based antibiotic to an allergic patient because this information is missing from the patient’s clinical records, which is avoided because the patient reads the prescription and reminds the practitioner of the allergy. Various studies estimate that many more near-miss incidents than real adverse events occur. In relation to the prescription of drugs, about seven times more incidents than complete adverse events are estimated to occur
Accident	An accident is defined as a random event, that is unforeseen and unexpected, and causes damage to the patient or to materials or to health care staff
Negligence	Negligence is defined as a mistake that is difficult to justify because it occurs through lack of knowledge or basic skills, the omission of minimal precautions, or neglect
Safety culture	An organisation’s culture of safety is the product of individual and group values, attitudes, perceptions, skills and patterns of behaviour which lead to commitment, style and ability in the management of the health and safety of an organisation. Those organisations with a positive safety culture are characterised by communication based on mutual trust, by shared perceptions of the importance of safety and by trust in the effectiveness of measures for prevention
Safety climate	The safety climate refers to shared perceptions of what an organisation is like with regard to safety