The High-Reliability Dental Surgical Environment: An Interdisciplinary Review of Safety, Efficiency, and Patient-Centered Care in the Ambulatory Operating Room
Abstract
Background: The migration of complex oral and maxillofacial surgery from inpatient hospital settings to freestanding or office-based dental operating rooms (DORs) represents a significant shift in care delivery. While increasing accessibility and efficiency, this transition concentrates substantial surgical and anesthetic risk within environments that may lack the ingrained safety culture and systemic protocols of traditional hospital operating rooms. Optimizing this setting is an urgent, interdisciplinary challenge. Aim: This narrative review aims to synthesize evidence and best practices for the design and operation of high-reliability DORs and surgical sedation suites. Methods: A systematic literature search (2010-2024) was conducted across PubMed, CINAHL, Scopus, Embase, and the databases of dental and anesthesiology societies. Results: The review identifies that a high-reliability DOR functions as a complex clinical microsystem requiring strict protocol adherence, clear communication hierarchies, and seamless information flow. Gaps persist in standardized training for ancillary staff and data interoperability. Conclusion: Excellence in the DOR is not a product of surgical skill alone but of a deliberately engineered system. It demands the full integration of clinical, technological, and administrative disciplines into a unified model that mirrors the safety standards of hospital surgery while preserving the efficiencies of ambulatory care. Future advancement hinges on collaborative research, shared metrics, and policy development that recognizes the unique complexity and risk profile of high-acuity dental surgery.
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Authors
Copyright (c) 2024 Saraa Ali Al-Bishi, Abdullah Obead Wasel Alhejaili, Mona Ali Albishi, Hessah Ahmed Mohamed Binjidah, Sheikah Abdrhman Ghazei Alotaibi, Saad Saqer Alqahtani, Waleed Majed Almutiri, Fayed Faleh Alharbi, Turayf Julayyil Awadh Alsharari, Reem Hassan Alqahtani, Sami Lahiq Alharbi, Mohammed Hamad Alhumaidi Alharbi
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