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瑞典的患者安全工作:年度患者安全报告的定量与定性分析

Patient safety work in Sweden: quantitative and qualitative analysis of annual patient safety reports.

作者信息

Ridelberg Mikaela, Roback Kerstin, Nilsen Per, Carlfjord Siw

机构信息

Department of Medical and Health Sciences, Division of Health Care Analysis, Linköping University, SE-581 83, Linköping, Sweden.

Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83, Linköping, Sweden.

出版信息

BMC Health Serv Res. 2016 Mar 21;16:98. doi: 10.1186/s12913-016-1350-5.

Abstract

BACKGROUND

There is widespread recognition of the problem of unsafe care and extensive efforts have been made over the last 15 years to improve patient safety. In Sweden, a new patient safety law obliges the 21 county councils to assemble a yearly patient safety report (PSR). The aim of this study was to describe the patient safety work carried out in Sweden by analysing the PSRs with regard to the structure, process and result elements reported, and to investigate the perceived usefulness of the PSRs as a tool to achieve improved patient safety.

METHODS

The study was based on two sources of data: patient safety reports obtained from county councils in Sweden published in 2014 and a survey of health care practitioners with strategic positions in patient safety work, acting as key informants for their county councils. Answers to open-ended questions were analysed using conventional content analysis.

RESULTS

A total of 14 structure elements, 31 process elements and 23 outcome elements were identified. The most frequently reported structure elements were groups devoted to working with antibiotics issues and electronic incident reporting systems. The PSRs were perceived to provide a structure for patient safety work, enhance the focus on patient safety and contribute to learning about patient safety.

CONCLUSION

Patient safety work carried out in Sweden, as described in annual PSRs, features a wide range of structure, process and result elements. According to health care practitioners with strategic positions in the county councils' patient safety work, the PSRs are perceived as useful at various system levels.

摘要

背景

不安全医疗问题已得到广泛认知,在过去15年里人们为提高患者安全付出了巨大努力。在瑞典,一项新的患者安全法要求21个郡议会编制年度患者安全报告(PSR)。本研究的目的是通过分析PSR中报告的结构、过程和结果要素来描述瑞典开展的患者安全工作,并调查PSR作为实现改善患者安全的工具的实际效用。

方法

本研究基于两个数据来源:从瑞典郡议会获取的2014年发布的患者安全报告,以及对在患者安全工作中担任战略职位的医疗从业者进行的调查,这些从业者作为其郡议会的关键信息提供者。使用常规内容分析法对开放式问题的答案进行分析。

结果

共识别出14个结构要素、31个过程要素和23个结果要素。报告频率最高的结构要素是致力于抗生素问题工作的小组和电子事件报告系统。PSR被认为为患者安全工作提供了一个框架,增强了对患者安全的关注,并有助于学习患者安全知识。

结论

年度PSR中描述的瑞典患者安全工作具有广泛的结构、过程和结果要素。据在郡议会患者安全工作中担任战略职位的医疗从业者称,PSR在各个系统层面都被认为是有用的。

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