Surgery and Cancer, Imperial College, London, UK
Surgery and Cancer, Imperial College, London, UK.
BMJ Open Qual. 2022 May;11(2). doi: 10.1136/bmjoq-2022-001849.
The current under-reporting of medical device malfunctions, difficulties with the current system and absence of continuous good-quality data has removed the possibility for constant data interrogation and trend recognition to identify evolving issues. This research used end user experiences aiming to understand causes for the lack of data and knowledge on device performance and associated patient risks. This approach was used to identify existing barriers and methods for improvement.
This is a qualitative study involving semistructured interviews and surveys with clinicians (15 interviews, 39 surveys) and manufacturers (13 interview participants, 5 surveys). Multiple sources of recruiting were used. Data collected were thematically analysed. Interview results were used to design the surveys. Standards for Reporting Qualitative Research was used.
Medical device use is based on personal experience rather than evidence which is scarce. Multiple barriers to reporting were identified alongside patient safety and system related aspects. Furthermore, the acceptable level of error was variable as were effects on working practice. Many workarounds have been developed to overcome problems and have become normalised in daily work. These factors were found to have a limiting impact on improvements and learning. Greater system transparency, feedback on submitted reports, a more efficient system of reporting and better communication with manufacturers were reported as some of the required improvements.
This study has identified numerous complex issues affecting reporting of medical device performance and their subsequent effect on patient safety and clinical staff. The focus on incidents has created many limitations to learning and development. The rich experience of end users should be appropriately used to identify system weaknesses and seek improvement methods. Better communication methods should be developed between healthcare and MedTech (Medical Technologies) industry.
当前,医疗器械故障的报告不足,当前系统存在困难,且缺乏持续高质量的数据,这使得人们无法进行持续的数据查询和趋势识别,以发现不断变化的问题。本研究利用终端用户的经验,旨在了解医疗器械性能数据和相关患者风险知识缺失的原因。这种方法用于确定现有的障碍和改进方法。
这是一项定性研究,涉及对临床医生(15 次访谈,39 次调查)和制造商(13 名访谈参与者,5 次调查)进行半结构化访谈和调查。使用了多种招募来源。收集的数据进行了主题分析。访谈结果用于设计调查。使用了定性研究报告标准。
医疗器械的使用基于个人经验,而非稀缺的证据。除了患者安全和系统相关方面,还确定了多个报告障碍。此外,报告错误的可接受水平以及对工作实践的影响各不相同。为了克服问题,已经开发了许多解决方法,并在日常工作中变得正常化。这些因素被发现对改进和学习有很大的限制。更大的系统透明度、对提交报告的反馈、更有效的报告系统以及与制造商更好的沟通,被认为是一些需要改进的方面。
本研究确定了许多影响医疗器械性能报告及其对患者安全和临床工作人员后续影响的复杂问题。对事件的关注给学习和发展带来了许多限制。终端用户的丰富经验应被恰当地用于识别系统弱点并寻求改进方法。应在医疗保健和医疗技术(医疗技术)行业之间开发更好的沟通方法。