1
|
Chia WC, Chen LS, Wang ST. The Intra-Hospital Medical Dispute Burden and Capacities: A Nationwide Survey in Taiwan. Healthcare (Basel) 2023; 11:2121. [PMID: 37570362 PMCID: PMC10419031 DOI: 10.3390/healthcare11152121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: Medical disputes have long been resolved via lawsuits. Alternative dispute resolutions have been promoted for their benefits and win-win results. This study aims to investigate Taiwanese hospital medical dispute capacities and burdens. (2) Methods: This study used 2015 nationwide questionnaire data. The number and value of medical disputes that occurred in 2014 was examined to evaluate hospitals' capabilities. Poisson regressions were used to determine the impact of coping abilities on the incidence of disputes and the associated compensation. (3) Results: The response rate of the questionnaire was 90%. Hospital features associated with higher medical disputes incidence included those of a scale ≤ 100 or 200-499 and having a dispute-inform process of over 4 h. In contrast, hospitals whose compensation fund was solely based on medical liability insurance reported less medical dispute incidence. The features associated with higher compensation were lack of continuing training and having a dispute-inform process over 4 h. In contrast, hospitals with standard operating procedures for in-hospital mediation and solicitude paid lower compensation. (4) Conclusions: Hospitals with quicker response times experienced fewer medical disputes and paid lower compensation. Dispute coping skills, other than reaction time, were more visible in compensation bargaining, but were not significantly correlated with incidence.
Collapse
Affiliation(s)
- Wen-Chun Chia
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan;
| | - Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Sen-Te Wang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan;
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| |
Collapse
|
2
|
Dhamanti I, Leggat S, Barraclough S, Liao HH, Abu Bakar N. Comparison of Patient Safety Incident Reporting Systems in Taiwan, Malaysia, and Indonesia. J Patient Saf 2021; 17:e299-e305. [PMID: 32217924 DOI: 10.1097/pts.0000000000000622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Incident reporting is one of the tools used to improve patient safety that has been widely used in health facilities in many countries. Incident reporting systems provide functionality to collect, analyze, and disseminate lessons learned to the wider community, whether at the hospital or national level. The aim of this study was to compare the patient safety incident reporting systems of Taiwan, Malaysia, and Indonesia to identify similarities, differences, and areas for improvement. METHODS We searched the official Web sites and homepages of the responsible leading patient safety agencies of the three countries. We reviewed all publicly available guidelines, regulatory documents, government reports that included policies, guidelines, strategy papers, reports, evaluation programs, as well as scientific articles and gray literature related to the incident reporting system. We used the World Health Organization components of patient safety reporting system as the guidelines for comparison and analyzed the documents using descriptive comparative analysis. RESULTS Taiwan had the most incidents reported, followed by Malaysia and Indonesia. Taiwan Patient Safety Reporting (TPR) and the Malaysian Reporting and Learning System had similar attributes and followed the World Health Organization components for incident reporting. We found differences between the Indonesian system and both of TPR and the Malaysian system. Indonesia did not have an external reporting deadline, analysis and learning were conducted at the national level, and there was a lack of transparency and public access to data and reports. All systems need to establish a clear and structured incident reporting evaluation framework if they are to be successful. CONCLUSIONS Compared with TPR and Malaysian system, the Indonesian patient safety incident reporting system seemed to be ineffective because it failed to acquire adequate national incident reporting data and lacked transparency; these deficiencies inhibited learning at the national level. We suggest further research on the implementation at the hospital level to see how far national guidelines and policy have been implemented in each country.
Collapse
Affiliation(s)
| | - Sandra Leggat
- School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Simon Barraclough
- School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | | | - Nor'Aishah Abu Bakar
- Patient Safety Unit, Medical Care Quality Section, Medical Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| |
Collapse
|
3
|
Sterz J, Ruesseler M, Seemann R, Münzberg M, Doepfer AK, Stange R, Mutschler M, Bouillon B, Egerth M. The acceptance of CIRS among orthopedic and trauma surgeons in Germany-Significant gap between positive perception and actual implementation in daily routine. J Orthop Surg (Hong Kong) 2020; 27:2309499019874507. [PMID: 31554465 DOI: 10.1177/2309499019874507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Medical errors are the third leading cause of death in the United States after malignant tumors and cardiovascular disease. Handling of errors becomes more and more eclectic due to the implementation of incident reporting systems and the use of checklists. Since 2015, any German hospital would have a critical incident reporting system (CIRS). The aim of this study is to discover the nationwide utilization and attitude toward CIRS of orthopedic and trauma surgeons. METHODS Between April 10, 2015 and May 22, 2015, a web-based questionnaire, which was designed by an expert team consisting of orthopedic and trauma surgeons, aeronautic human factors specialists, and psychologists (Lufthansa Aviation Training), was sent to all members of the German Society for Orthopedic and Trauma Surgery. The survey consisted of three questions regarding CIRS and its use in German hospitals. RESULTS A total of 669 orthopedic and trauma surgeons working in German hospitals completed the questionnaire. All participants rated CIRS as useful, although 71.3% of participants did not report a critical incident in the last 12 months. In that time period, only 13.4% of participating residents reported at least one incident, but 44.7% of chief physicians reported one incident within the same period. CONCLUSION The present study demonstrates that even though CIRS as a tool is positively appreciated by orthopedic and trauma surgeons working in German hospitals, many do not know about its existence at their own hospital. This can be a reason for the low number of critical incidents reported.
Collapse
Affiliation(s)
- Jasmina Sterz
- Department for Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Miriam Ruesseler
- Department for Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Ricarda Seemann
- Center for Musculoskeletal Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Münzberg
- Department of Trauma and Orthopedic Surgery, BG-Klinik Ludwigshafen, Ludwigshafen, Germany
| | | | - Richard Stange
- Department for Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany
| | - Manuel Mutschler
- Department for Orthopedic Surgery, Trauma Surgery and Sport Injuries, Kliniken der Stadt Köln, Cologne, Germany
| | - Bertil Bouillon
- Department for Orthopedic Surgery, Trauma Surgery and Sport Injuries, Kliniken der Stadt Köln, Cologne, Germany
| | - Martin Egerth
- Department of Human Factors Training, Lufthansa Aviation Training, Berlin, Germany
| |
Collapse
|
4
|
Feeser VR, Jackson A, Senn R, Layng T, Santen SA, Creditt AB, Dhindsa HS, Vitto MJ, Savage NM, Hemphill RR. Patient Safety Event Reporting and Opportunities for Emergency Medicine Resident Education. West J Emerg Med 2020; 21:900-905. [PMID: 32726262 PMCID: PMC7390572 DOI: 10.5811/westjem.2020.3.46018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/09/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Healthcare systems often expose patients to significant, preventable harm causing an estimated 44,000 to 98,000 deaths or more annually. This has propelled patient safety to the forefront, with reporting systems allowing for the review of local events to determine their root causes. As residents engage in a substantial amount of patient care in academic emergency departments, it is critical to use these safety event reports for resident-focused interventions and educational initiatives. This study analyzes reports from the Virginia Commonwealth University Health System to understand how the reports are categorized and how it relates to opportunities for resident education. Methods Identifying categories from the literature, three subject matter experts (attending physician, nursing director, registered nurse) categorized an initial 20 reports to resolve category gaps and then 100 reports to determine inter-rater reliability. Given sufficient agreement, the remaining 400 reports were coded individually for type of event and education among other categories. Results After reviewing 513 events, we found that the most common event types were issues related to staff and resident training (25%) and communication (18%), with 31% requiring no education, 46% requiring directed educational feedback to an individual or group, 20% requiring education through monthly safety updates or meetings, 3% requiring urgent communication by email or in-person, and <1% requiring simulation. Conclusion Twenty years after the publication of To Err is Human, gains have been made integrating quality assurance and patient safety within medical education and hospital systems, but there remains extensive work to be done. Through a review and analysis of our patient safety event reporting system, we were able to gain a better understanding of the events that are submitted, including the types of events and their severity, and how these relate to the types of educational interventions provided (eg, feedback, simulation). We also determined that these events can help inform resident education and learning using various types of education. Additionally, incorporating residents in the review process, such as through root cause analyses, can provide residents with high-quality, engaging learning opportunities and useful, lifelong skills, which is invaluable to our learners and future physicians.
Collapse
Affiliation(s)
- V Ramana Feeser
- Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia
| | - Anne Jackson
- Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia
| | - Regina Senn
- Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia
| | - Timothy Layng
- Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia
| | - Sally A Santen
- Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia
| | - Angela B Creditt
- Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia
| | - Harinder S Dhindsa
- Virginia Commonwealth University Health System, Department of Emergency Medicine, Division of Emergency Medical Services, Richmond, Virginia
| | - Michael J Vitto
- Virginia Commonwealth University School of Medicine, Department of Emergency Medicine, Richmond, Virginia
| | - Nastassia M Savage
- Virginia Commonwealth University School of Medicine, Office of Assessment, Evaluation, and Scholarship, Richmond, Virginia
| | - Robin R Hemphill
- Virginia Commonwealth University Health System, Department of Emergency Medicine, Richmond, Virginia
| |
Collapse
|
5
|
Dhamanti I, Leggat S, Barraclough S, Tjahjono B. Patient Safety Incident Reporting In Indonesia: An Analysis Using World Health Organization Characteristics For Successful Reporting. Risk Manag Healthc Policy 2019; 12:331-338. [PMID: 31849549 PMCID: PMC6913760 DOI: 10.2147/rmhp.s222262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/02/2019] [Indexed: 11/23/2022] Open
Abstract
Background Incident reporting is widely acknowledged as one of the ways of improving patient safety and has been implemented in Indonesia for more than ten years. However, there was no significant increase in the number of reported incidents nationally. The study described in this paper aimed at assessing the extent to which Indonesia’s patient safety incident reporting system has adhered to the World Health Organization (WHO) characteristics for successful reporting. Methods We interviewed officials from 16 organizations at national, provincial and district or city levels in Indonesia. We reviewed several policies, guidelines and regulations pertinent to incident reporting in Indonesia and examined whether the WHO characteristics were covered in these documents. We used NVivo version 9 to manage the interview data and applied thematic analysis to organize our findings. Results Our study found that there was an increased need for a non-punitive system, confidentiality, expert-analysis and timeliness of reporting, system-orientation and responsiveness. The existing guidelines, policies and regulations in Indonesia, to a large extent, have not satisfied all the required WHO characteristics of incident reporting. Furthermore, awareness and understanding of the reporting system amongst officials at almost all levels were lacking. Conclusion Despite being implemented for more than a decade, Indonesia’s patient safety incident reporting system has not fully adhered to the WHO guidelines. There is a pressing need for the Indonesian Government to improve the system, by putting specific regulations and by creating a robust infrastructure at all levels to support the incident reporting.
Collapse
Affiliation(s)
- Inge Dhamanti
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.,Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Sandra Leggat
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Simon Barraclough
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Benny Tjahjono
- Centre for Business in Society, Coventry University, Coventry, UK
| |
Collapse
|
6
|
Lin SY, Yang HC, Chiang HY, Lee SL. A cross-validation study of the incident-reporting attitude scale for staff in long-term care facilities-A cross-sectional study. J Clin Nurs 2019; 28:2858-2867. [PMID: 30938895 DOI: 10.1111/jocn.14869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 01/28/2019] [Accepted: 03/23/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To test the construct and concurrent validity and reliability of the incident-reporting attitude scale used for staff in long-term care facilities (IRA-LTC) by the two-phase cross-validation method. BACKGROUND Lack of accurate measurement on incident-reporting attitude might hinder improvements of safety practice in long-term care facilities. DESIGN/METHODS A two-phase cross-sectional questionnaire survey was conducted in Taiwan. A fixed proportion of long-term care facilities were randomly selected that included 20 and 15 long-term care facilities at phases one and two separately. Nursing and administrative staffs in these facilities were recruited at the first phase (N = 207) for testing the validity and reliability of the newly developed scale and for cross-validation of the scale at the second phase (N = 251). The scale of IRA-LTC was a self-developed structured questionnaire consisting of 31 items. The data were analysed using spss for Windows 20.0 and AMOS 24.0. Descriptive statistics, correlation analysis, Cronbach's α, exploratory and confirmatory factory analysis were carried to examine the homogeneity of items, reliability, construct and concurrent validity. The STROBE checklist was adhered (See Appendix S1). RESULTS The IRA-LTC scale comprised two dimensions: "cognition and intention to report" and "barriers to report." The two-factor structure explained 60.20%-61.89% of the total variance at two phases. Validation of the initial factorial model gained at the first phase was satisfactorily supported at the second phase. Concurrent validity of the IRA-LTC scale was satisfied. Cronbach's α for the scale and subscales was 0.94-0.97. CONCLUSIONS This IRA-LTC scale is valid and reliable and can be recommended to evaluate the incident-reporting attitude among all kinds of staff in long-term care facilities. RELEVANCE TO CLINICAL PRACTICE Positive incident-reporting attitude can lead to positive incident-reporting behaviour. Using the IRA-LTC scale for assessing staff's incident-reporting attitude is recommended as the first step to enhance staff's safety performance in long-term care facilities.
Collapse
Affiliation(s)
- Shu-Yuan Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Ching Yang
- College of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Hui-Ying Chiang
- Nursing Department, Chi Mei Medical Center, Yung Kang, Taiwan.,College of Humanities and Social Sciences, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Nursing, Chang Jung Christian University, Tainan, Taiwan
| | - Shu-Li Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
7
|
Gao X, Yan S, Wu W, Zhang R, Lu Y, Xiao S. Implications from China patient safety incidents reporting system. Ther Clin Risk Manag 2019; 15:259-267. [PMID: 30799925 PMCID: PMC6371930 DOI: 10.2147/tcrm.s190117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We aimed to explain the operational mechanism of China National Patient Safety Incidents Reporting System, analyze patterns and trends of incidents reporting, and discuss the implication of the incidents reporting to improve hospital patient safety. Design A nationwide, registry-based, observational study design. Data source The database of China National Patient Safety Incidents Reporting System. Outcome measures Outcome measures of this study included the temporal, regional, and hospital distribution of the reports, as well as the incident type, location, parties, and possible reasons for frequently occurring incidents. Results During 2012–2017, 36,498 patient safety incidents were reported. By analyzing the time trends, we found that there was a significant upward trend on incidents reporting in China. The most common type of incidents was drug-related incidents, followed by nursing-related incidents and surgery-related incidents. The three most frequent locations of incident occurrence were Patient’s Room (65.4%), Ambulatory Care Unit (8.4%), and Intensive Care Unit (7.4%). The majority of the incidents involved nurses (40.7%), followed by physicians (29.5%) and medical technologist (13.6%). About 44.4% of the incidents were attributed to the junior staff (work experience ≤5 years). In addition, incidents triggered by the senior staff (work experience >5 years) were more often associated with severe patient harm. Conclusion To strengthen the incidents reporting system and generate useful evidence through learning from incidents reporting will be important to China’s success in improving the nation’s patient safety status.
Collapse
Affiliation(s)
- Xinqiang Gao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China,
| | - Shipeng Yan
- Department of Cancer Prevention and Control, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Wenqiong Wu
- Department of Cancer Prevention and Control, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
| | - Rui Zhang
- Department of Health Policy and Management, School of Public Health, Peiking University, Peiking, China
| | - Yuliang Lu
- Department of the Medical Affairs, Binzhou Medical University Hospital, Binzhou Medical University, Bingzhou, Shandong Province, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China,
| |
Collapse
|
8
|
Vossoughi S, Parker‐Jones S, Schwartz J, Stotler B. Provider trends in paediatric and adult transfusion reaction reporting. Vox Sang 2019; 114:232-236. [DOI: 10.1111/vox.12758] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/07/2019] [Accepted: 01/13/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Vossoughi
- Department of Pathology Columbia University Irving Medical Center New York NY USA
| | - Sylvia Parker‐Jones
- Department of Pathology Columbia University Irving Medical Center New York NY USA
- Department of Transfusion Medicine New York‐Presbyterian Hospital New York NY USA
| | - Joseph Schwartz
- Department of Pathology Columbia University Irving Medical Center New York NY USA
| | - Brie Stotler
- Department of Pathology Columbia University Irving Medical Center New York NY USA
- Department of Transfusion Medicine New York‐Presbyterian Hospital New York NY USA
| |
Collapse
|