Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA.
Am J Obstet Gynecol. 2011 Jul;205(1):7-9. doi: 10.1016/j.ajog.2010.12.020. Epub 2011 Feb 2.
Obstetric caregivers are plagued with lawsuits alleging negligence for suboptimal outcomes. Some of those claims are unjustified, but many have merit. We are obligated to create systems designed to minimize the potential for errors that harm our patients. A variety of safety initiatives have been shown to improve patient outcomes in several centers in the United States, but it has been difficult to document the expected association between those results and reduced liability premiums. Furthermore, some individuals and institutions have been reluctant to adopt safety tools such as electronic fetal monitoring certification for all staff working on their Labor and Delivery floor, protocols for managing common clinical scenarios, simulation drills for dealing with uncommon dangerous events, and pre-procedure checklists because of the paucity of evidence based data documenting the effectiveness of those approaches. It is time to move forward with these and other safety initiatives in a serious national attempt to eliminate all preventable adverse patient outcomes in our specialty.
产科护理人员因治疗效果不佳而被起诉疏忽，有些指控是没有根据的，但也有很多是合理的。我们有责任建立旨在最大限度减少伤害患者的潜在错误的系统。在美国的多个中心，各种安全措施已被证明可以改善患者的预后，但很难证明这些结果与降低责任保险费之间存在预期的关联。此外，由于缺乏基于证据的有效数据来证明这些方法的效果，一些个人和机构一直不愿意采用安全工具，如对所有在产房工作的员工进行电子胎儿监护认证、管理常见临床情况的方案、处理罕见危险事件的模拟演练，以及术前检查表。现在是时候在全国范围内认真推进这些和其他安全措施，以努力消除我们专业领域的所有可预防的不良患者预后。
