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住院医师上报不良事件障碍的解决方案。

Possible solutions for barriers in incident reporting by residents.

机构信息

Foreest Medical School, Medical Center Alkmaar, Alkmaar, The Netherlands.

出版信息

J Eval Clin Pract. 2012 Feb;18(1):76-81. doi: 10.1111/j.1365-2753.2010.01544.x. Epub 2010 Oct 25.

Abstract

RATIONALE, AIMS AND OBJECTIVES: Incident reporting can contribute to safer health care. Since the rate of reporting by residents is low, it is useful to investigate which barriers exist and how these can be solved.

METHODS

Data were collected in a large teaching hospital in the Netherlands. The hospital uses a confidential, voluntary and web-based incident reporting system. Residents working in the hospital participated in focus group discussions to explore barriers and possible solutions. A grounded theory approach was used to analyse the transcribed discussions.

RESULTS

In each focus group six to eight residents participated, resulting in a total number of 22 participants. After three focus group discussions, information saturation had been reached. Residents do not report all incidents because of a negative attitude towards incident reporting, because they experience a non-stimulating culture and because of a lack of perceived ability to report. Residents suggest several solutions to solve the barriers: providing the possibility to report anonymously, providing feedback, creating an incident reporting culture, simplifying the procedure, clarifying what and how to report, and exciting residents to report.

CONCLUSIONS

Residents have useful suggestions to resolve the barriers that prevent them from reporting incidents. They include solutions that influence attitude, culture and perceived ability. These suggestions should be considered when making an effort to improve incident reporting by residents.

摘要

背景、目的和目标:事件报告有助于实现更安全的医疗保健。由于住院医师的报告率较低,因此调查存在哪些障碍以及如何解决这些障碍非常有用。

方法

数据收集于荷兰的一家大型教学医院。该医院使用机密、自愿和基于网络的事件报告系统。在医院工作的住院医师参加了焦点小组讨论,以探讨障碍和可能的解决方案。采用扎根理论方法对转录的讨论进行分析。

结果

每个焦点小组有六到八名住院医师参加,共有 22 名参与者。经过三轮焦点小组讨论,达到了信息饱和。住院医师没有报告所有事件,因为他们对事件报告持消极态度,因为他们体验到非激励性的文化,并且因为他们认为自己没有能力报告。住院医师提出了一些解决方案来解决这些障碍:提供匿名报告的可能性,提供反馈,营造事件报告文化,简化程序,澄清报告的内容和方式,并激发住院医师报告的积极性。

结论

住院医师对解决阻碍他们报告事件的障碍提出了有用的建议。这些建议包括影响态度、文化和感知能力的解决方案。在努力改善住院医师的事件报告时,应考虑这些建议。

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