1
|
Vaisman A, Guiloff R, Contreras M, Casas-Cordero JP, Calvo R, Figueroa D. Over 50% of self-reported burnout among Latin American orthopaedic surgeons: A cross-sectional survey on prevalence and risk factors. J ISAKOS 2024; 9:128-134. [PMID: 38036044 DOI: 10.1016/j.jisako.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Assess the prevalence of self-reported burnout and identify risk and protective factors based on demographic and life quality aspects, among Latin American orthopaedic surgeons. METHODS This study employed a cross-sectional analytical design. An original design survey was developed using multiple-choice and Likert-scale questions to gather self-reported burnout, demographic, work-related, social, personal, and mood-related data. The survey was electronically distributed to the Chilean Orthopaedic Surgery Society and the Latin American Society of Arthroscopy, Knee Surgery, and Sports Medicine members. Statistical analysis included Chi-square and Fisher's exact tests to determine associations between self-reported burnout and other variables. Subsequently, a multivariate logistic regression was carried out to identify key risk and protective factors (p < 0.05). RESULTS The survey's response rate was 20 % (n = 358) out of the 1779 invitations that were sent. The most representative age range was 41-60 years (50 %) and 94 % were men. Of those surveyed, 50 % reported a burnout episode more than once per year, 60 % depersonalization when treating patients at least yearly, 13 % anhedonia, 11 % a depressive mood more than half of the month or almost every day, and 61 % weariness at the end of a working day. Burnout was statistically associated with age under 40 years old (p = 0.012), fewer years as a specialist (p = 0.037), fear of lawsuits (p < 0.001), a non-healthy diet (p = 0.003), non-doing recreational activities (p = 0.004), depersonalization when treating their patients (p < 0.001), weariness (p < 0.001), anhedonia (p < 0.001), depressive mood (p < 0.001), and career dissatisfaction (p < 0.001). The logistic regression demonstrated that fear of lawsuits (p < 0.001), weariness at the end of a workday (p = 0.016), and anhedonia (p = 0.019) were those variables with stronger direct associations with self-reported burnout. A healthy diet was the strongest protective variable (p < 0.001). CONCLUSION Over 50 % of the Latin American orthopaedic surgeons who participated in the survey reported experiencing burnout episodes more than once a year, along with depersonalization when treating their patients at least once a year. Additionally, nearly 10 % of respondents experienced weekly depressive symptoms. Among the noteworthy risk factors for self-reported burnout were fear of lawsuits, weariness at the end of the workday, and anhedonia. Conversely, maintaining a healthy diet emerged as the most potent protective factor. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Alex Vaisman
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| | - Rodrigo Guiloff
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile.
| | - Martín Contreras
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Av. Plaza 680, 7610658, Las Condes, Santiago, Chile
| | - Juan Pablo Casas-Cordero
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Av. Plaza 680, 7610658, Las Condes, Santiago, Chile
| | - Rafael Calvo
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| | - David Figueroa
- Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Departamento Traumatología, Av. Vitacura 5951, 7650568, Santiago, Chile
| |
Collapse
|
2
|
Fedeli P, Cecchi S, Scendoni R, Cannovo N. Legal medicine aspects of female sterilization: our experience. Front Med (Lausanne) 2023; 10:1198668. [PMID: 37497276 PMCID: PMC10367092 DOI: 10.3389/fmed.2023.1198668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. It may be performed via laparoscopy, mini-laparotomy, or hysteroscopy. Safety, efficacy, short-term complications, long-term complications, and non-contraceptive benefits of sterilization are different for each procedure. Female sterilization has become an important professional liability problem in obstetrics and gynecology. Materials and methods We analyzed 6 cases of surgical sterilization that have been the subject of civil proceedings. We review indications, contraindications, and complications associated with each sterilization procedure. Results In our small number of cases, women who have undergone sterilization performed negligently are entitled to recover damages for wrongful conception, negligence, and wrongful birth. We also consider the issue of female sterilization of minors. Discussion Tubal sterilization can be performed with different techniques, chosen in light of the various situations involved, with the goal of reducing as many as possible any failures. Thorough and complete communication of information is of primary importance. Conclusion Sterilization is the most widely used birth control method around the world. The procedure is generally safe and highly effective. As reported in the literature, the decision concerning method depends on the setting, the surgeon's experience, the country's economic development, and the woman's preference, but we think that some techniques present a greater risk of failure and expose the surgeon to malpractice litigation.
Collapse
Affiliation(s)
| | - Stefano Cecchi
- U.O.C. Ginecologia ed Ostetricia, Ospedale Generale Provinciale, AST Macerata, Macerata, Italy
| | - Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | | |
Collapse
|
3
|
Austin EE, Do V, Nullwala R, Fajardo Pulido D, Hibbert PD, Braithwaite J, Arnolda G, Wiles LK, Theodorou T, Tran Y, Lystad RP, Hatem S, Long JC, Rapport F, Pantle A, Clay-Williams R. Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance. BMJ Open 2021; 11:e050377. [PMID: 34429317 PMCID: PMC8386219 DOI: 10.1136/bmjopen-2021-050377] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/05/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners. DESIGN Systematic review. DATA SOURCES Ovid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched. RESULTS Sixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out. CONCLUSIONS It is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor's risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm. PROSPERO REGISTRATION NUMBER PROSPERO registration number: CRD42020182045.
Collapse
Affiliation(s)
- Elizabeth E Austin
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Vu Do
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Ruqaiya Nullwala
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Diana Fajardo Pulido
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Peter D Hibbert
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Gaston Arnolda
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Louise K Wiles
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Tahlia Theodorou
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Sarah Hatem
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Annette Pantle
- Medical Council of New South Wales, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
4
|
Hsieh MT, Lu LH, Lin CW, Chen YW. Correlation Between Malpractice Litigation and Legislation Reform in Taiwan Over a 30-Year Period. Int J Gen Med 2021; 14:1889-1898. [PMID: 34040421 PMCID: PMC8139722 DOI: 10.2147/ijgm.s312640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background The annual medical litigation rate has increased yearly since 1987 in Taiwan. Policy makers keep going medical legislation reforms. The effectiveness of legislation reforms to reduce malpractice litigation risk is uncertain. Objective To determine whether medical legislation reform helps reduce the risk of medical litigation. Design, Setting, and Participants This retrospective study used national data obtained from Ministry of Health and Welfare in Taiwan. The period analyzed was from 1987 to 2018. The annual medical litigation rate was determined, types of medical negligence litigation were compared, medical appraisal results were summarized, and the importance of medical legislation was identified. Interventions After legislation reform vs before legislation reform. Measurements The main outcome showed trends in medical dispute assessments over time by adjusting for the general population (per 1, 000, 000 people). We established 2004 and 2012 as the 2 cut-points for further analysis of medical appraisal results due to legislation reform. Results With legislation reforms, the annual medical litigation rate decreased from 26.68 cases per million people in 2012 to 16.41 cases per million people in 2018. The annual medical litigation rate declined by approximately 38% from 2012 to 2018. Medical appraisal results were malpractice cases in 22.1% before Medical Care Act (2004 Reform) compared with 18.8% from 2004 to 2012 (odds ratio [OR], 0.82; 95% CI, 0.727–0.924; p=0.001), and 6.4% after mediation system introduced in 2012 (odds ratio [OR], 0.243; 95% CI, 0.205–0.288; p<0.001). Conclusion Medical legislation reform has reduced the risk of malpractice litigation over time.
Collapse
Affiliation(s)
- Ming-Ta Hsieh
- Department of Family Medicine and Community Medicine, E-Da Hospital, Kaohsiung City, Taiwan.,College of Law, National University of Kaohsiung, Kaohsiung City, Taiwan.,Department of Nursing, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Li-Hui Lu
- College of Law, National University of Kaohsiung, Kaohsiung City, Taiwan
| | - Chi-Wei Lin
- Department of Family Medicine and Community Medicine, E-Da Hospital, Kaohsiung City, Taiwan.,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Yun-Wen Chen
- Pediatrician, Local Clinic, Kaohsiung City, Taiwan
| |
Collapse
|
5
|
Abstract
Introduction Dental litigation accounts for approximately 10% of medical cases in Japan. This study sought to identify factors related to dentists’ legal liability in Japan, including their duty to explain procedures and treatments to their patients. Methods We analysed court decisions in 166 dental malpractice cases litigated in Japan between 1978 and 2017. To identify factors related to the legal liability of dentists, an analysis was performed to evaluate the associations among patient characteristics, dentist characteristics, litigation, and dentists’ explanatory behaviour. Results Of the 36 cases related to dentist liability, the study identified 23 cases (63.9%) of litigation in which the dentists were found to be in violation of their duty to provide an explanation. Regarding the severity of injury, the ratio of death and permanent disability was significantly higher in decisions in which the purpose of the explanation was something other than obtaining the patient's consent compared with decisions to obtain the patient's consent (P = .014). Conclusions In cases in which the dentist was found legally responsible, the proportion of cases involving procedural negligence with the explanation of medical guidance was significantly higher. Dentists should pay careful attention not only to the patient's consent but also to their explanations, including “medical guidance.” Moreover, they should recognise that inappropriate explanations correlate with serious errors.
Collapse
Affiliation(s)
- Tomoko Hamasaki
- Department of Nutrition, Faculty of Home Economics, Kyushu Women's University, Kitakyushu, Fukuoka, Japan.
| | - Akihito Hagihara
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| |
Collapse
|
6
|
Veerman MM, van der Woude LA, Tellier MA, Legemaate J, Scheltinga MR, Stassen LPS, Leclercq WKG. A decade of litigation regarding surgical informed consent in the Netherlands. PATIENT EDUCATION AND COUNSELING 2019; 102:340-345. [PMID: 30173877 DOI: 10.1016/j.pec.2018.08.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 08/24/2018] [Accepted: 08/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE An inadequate surgical informed consent process (SIC) may result in a medical malpractice claim or medical disciplinary board (MDB) complaint. Aim of this study was to analyse characteristics of a decade of malpractice claims and MDB decisions regarding SIC in the Netherlands. METHODS A retrospective analysis of malpractice claims and MDB decisions concerning SIC disputes in four major surgical specialties was conducted based on company data from the largest medical malpractice insurance company and two public available online MDB databases. RESULTS A total of 11376 malpractice claims and 661 MDB complaints were filed between 2004-2013 and 676(6%) of these claims and 69(10%) of these complaints involved an alleged deficient SIC process. A random sample of 245(37%) claims and all MDB decisions were analysed. Reasons for filing a claim or complaint were insufficient counselling or recording of SIC elements. In 20% of lawsuits and 25% of claims the case resulted in favour of the complainant. CONCLUSION A substantial portion of malpractice claims and MDB decisions is related to a deficient SIC process. PRACTICE IMPLICATIONS Focusing on crucial SIC elements for patients may improve satisfaction and expectations and result in a lower risk for malpractice claims and MDB complaints.
Collapse
Affiliation(s)
- M M Veerman
- Department of Plastic Surgery, Rivierenland Hospital, Tiel, The Netherlands; Department of Surgery, Máxima Medisch Centrum, Eindhoven - Veldhoven, The Netherlands
| | - L A van der Woude
- Department of Plastic Surgery, Rivierenland Hospital, Tiel, The Netherlands; Department of Plastic Surgery, Isala klinieken, Zwolle, The Netherlands; Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, Máxima Medisch Centrum, Eindhoven - Veldhoven, The Netherlands
| | - M A Tellier
- Department of Plastic Surgery, Isala klinieken, Zwolle, The Netherlands
| | - J Legemaate
- Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - M R Scheltinga
- Department of Plastic Surgery, Rivierenland Hospital, Tiel, The Netherlands; Department of Plastic Surgery, Isala klinieken, Zwolle, The Netherlands; Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, Máxima Medisch Centrum, Eindhoven - Veldhoven, The Netherlands
| | - L P S Stassen
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - W K G Leclercq
- Department of Plastic Surgery, Rivierenland Hospital, Tiel, The Netherlands; Department of Plastic Surgery, Isala klinieken, Zwolle, The Netherlands; Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, Máxima Medisch Centrum, Eindhoven - Veldhoven, The Netherlands.
| |
Collapse
|
7
|
Li Y, Gao D, Liang W, Qiu L, Liu X, Zhang L, Deng Z. A comparison of malpractice lawsuits mediated and judged in court in China. J Forensic Leg Med 2018; 54:109-113. [DOI: 10.1016/j.jflm.2018.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/17/2018] [Accepted: 01/23/2018] [Indexed: 10/18/2022]
|
8
|
|
9
|
Hamasaki T, Hagihara A. A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments. BMC Med Ethics 2015; 16:72. [PMID: 26498823 PMCID: PMC4619401 DOI: 10.1186/s12910-015-0065-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 10/12/2015] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to review the typical factors related to physician’s liability in obstetrics and gynecology departments, as compared to those in internal medicine and surgery, regarding a breach of the duty to explain. Methods This study involved analyzing 366 medical litigation case reports from 1990 through 2008 where the duty to explain was disputed. We examined relationships between patients, physicians, variables related to physician’s explanations, and physician’s breach of the duty to explain by comparing mean values and percentages in obstetrics and gynecology, internal medicine, and surgical departments with the t-test and χ2 test. Results When we compared the reasons for decisions in cases where the patient won, we found that the percentage of cases in which the patient’s claim was recognized was the highest for both physician negligence, including errors of judgment and procedural mistakes, and breach of the duty to explain, in obstetrics and gynecology departments; breach of the duty to explain alone in internal medicine departments; and mistakes in medical procedures alone in surgical departments (p = 0.008). When comparing patients, the rate of death was significantly higher than that of other outcomes in precedents where a breach of the duty to explain was acknowledged (p = 0.046). The proportion of cases involving obstetrics and gynecology departments, in which care was claimed to be substandard at the time of treatment, and that were not argued as breach of a duty to explain, was significantly higher than those of other evaluated departments (p <0.001). However, internal medicine and surgical departments were very similar in this context. In obstetrics and gynecology departments, the proportion of cases in which it had been conceded that the duty to explain had been breached when seeking patient approval (or not) was significantly higher than in other departments (p = 0.002). Conclusion It is important for physicians working in obstetrics and gynecology departments to carefully explain the risk of death associated with any planned procedure, and to obtain genuinely informed patient consent.
Collapse
Affiliation(s)
- Tomoko Hamasaki
- Department of Nutrition Faculty of Home Economics, Kyushu Women's University 1-1 Jiyugaoka Yahatanishi, Kitakyushu, Fukuoka, 807-8586, Japan.
| | - Akihito Hagihara
- Department of Health Services Management and Policy, Kyushu University Graduate School of Medicine, Higashi-ku, Fukuoka, 812-8582, Japan.
| |
Collapse
|
10
|
Enjoo SA, Amini M, Tabei SZ, Mahbudi A, Kavosi Z, Saber M. The main indicators for Iranian hospital ethical accreditation. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2015; 3:117-32. [PMID: 26269789 PMCID: PMC4530002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/26/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The application of organizational ethics in hospitals is one of the novel ways to improve medical ethics. Nowadays achieving efficient and sufficient ethical hospital indicators seems to be inevitable. In this connection, the present study aims to determine the best indicators in hospital accreditation. METHODS 69 indicators in 11 fields to evaluate hospital ethics were achieved through a five-step qualitative and quantitative study including literature review, expert focus group, Likert scale survey, 3 rounded Delphi, and content validity measurement. Expert focus group meeting was conducted, employing Nominal Group Technique (NGT). After running NGT, a three rounded Delphi and parallel to Delphi and a Likert scale survey were performed to obtain objective indicators for each domain. The experts were all healthcare professionals who were also medical ethics researchers, teachers, or PhD students. Content validity measurements were computed, using the viewpoints of two different expert groups, some ethicists, and some health care professionals (n=46). RESULTS After conducting NGT, Delphi, Likert survey, 11 main domains were listed including: Informed consent, Medical confidentiality, Physician-patient economic relations, Ethics consultation policy in the hospital, Ethical charter of hospital, Breaking bad medical news protocol, Respect for the patients' rights, Clinical ethics committee, Spiritual and palliative care unit programs in the hospitals, Healthcare professionals' communication skills, and Equitable access to the healthcare. Also 71 objective indicators for these 11 domains were listed in 11 tables with 5 to 8 indicators per table. Content Validity Ratio (CVR) measurements were done and 69 indicators were highlighted. CONCLUSION The domains listed in this study seem to be the most important ones for evaluating hospital ethics programs and services. Healthcare organizations' accreditation and ranking are crucial for the improvement of healthcare services. Ethics programs would also motivate hospitals to improve their services and move towards patients' satisfaction. In this regard, more involvement of bioethicists can help healthcare organizations to develop ethics programs and ensure ethics-based practice in hospitals.
Collapse
Affiliation(s)
- Seyed Ali Enjoo
- Medical Ethics Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Amini
- Quality Improvement in Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ziaadin Tabei
- Medical Ethics Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mahbudi
- Quality Improvement in Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kavosi
- Social Determinants of Health Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh Saber
- Medical Ethics Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
11
|
Abstract
This paper discusses the definition, nature and origins of clinical errors including their prevention. The relationship between clinical errors and medical negligence is examined as are the characteristics of litigants and events that are the source of litigation. The pattern of malpractice claims in different specialties and settings is examined. Among hospitalized patients worldwide, 3-16% suffer injury as a result of medical intervention, the most common being the adverse effects of drugs. The frequency of adverse drug effects appears superficially to be higher in intensive care units and emergency departments but once rates have been corrected for volume of patients, comorbidity of conditions and number of drugs prescribed, the difference is not significant. It is concluded that probably no more than 1 in 7 adverse events in medicine result in a malpractice claim and the factors that predict that a patient will resort to litigation include a prior poor relationship with the clinician and the feeling that the patient is not being kept informed. Methods for preventing clinical errors are still in their infancy. The most promising include new technologies such as electronic prescribing systems, diagnostic and clinical decision-making aids and error-resistant systems.
Collapse
Affiliation(s)
- Femi Oyebode
- University of Birmingham, National Centre for Mental Health, Birmingham, UK.
| |
Collapse
|