Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark.
BMJ Open Qual. 2024 May 29;13(2):e002745. doi: 10.1136/bmjoq-2024-002745.
Patient safety is a high priority in the Danish health care system, including that hospital patients get the proper nutrition during their stay. A Nutrition Committee at Odense University Hospital is responsible for policy regarding nourishment at the hospital. If patients experience suboptimal treatment, i.e. improper nourishment, in the Danish health care system, they have the right to file a complaint. These complaints enable the improvement potentials based on the patients' first hand experiences. Therefore, our aim was to examine the nutrition complaint pattern and to get a deeper understanding of the context surrounding nutrition problems, allowing the extraction of learning potentials.
We analysed complaints submitted to Odense University Hospital between 2018 and 2022 using the Healthcare Complaint Analysis Tool. The complaints were categorised into categories, levels of severity and overall patient harm. The complaints containing a high-severity nutrition problem were read through and thematised into aspects not defined in the Healthcare Complaint Analysis Tool.
Between 2018 and 2022, 60 complaint cases containing 89 nutrition problems were filed to Odense University Hospital. Most (58.3%) of these were filed by the patients' relatives. The nutrition problems were mostly of low severity (56.2%), while 23.6% were severe, and 20.2% were very severe. The reading of 18 very severe nutrition complaints revealed a cascade of problems triggered by the nutrition problem in six cases. Moreover, we saw that two high-severity nutrition problems led to catastrophic harm.
A low proportion of nutrition problems may express an underestimation regarding nourishment at the hospital. A patient's threshold may not be exceeded by suboptimal nutrition and therefore does not file a complaint. However, complaints contain important insights contributing to wider learning, given that improvements at the hospital so far are based on clinicians' reporting, overlooking the patient perspective.
患者安全是丹麦医疗保健系统的重中之重，包括确保住院患者在住院期间获得适当的营养。奥胡斯大学医院的营养委员会负责制定医院营养政策。如果患者在丹麦医疗保健系统中接受的治疗不理想，即营养不当，他们有权提出投诉。这些投诉使我们能够根据患者的第一手经验发现改进的潜力。因此，我们的目的是检查营养投诉模式，并更深入地了解营养问题的背景，从而挖掘学习的潜力。
我们使用医疗保健投诉分析工具分析了 2018 年至 2022 年期间向奥胡斯大学医院提交的投诉。投诉被分为类别、严重程度级别和总体患者伤害级别。对包含高严重性营养问题的投诉进行了通读，并将未在医疗保健投诉分析工具中定义的方面进行了主题化。
2018 年至 2022 年间，奥胡斯大学医院共收到 60 份包含 89 个营养问题的投诉案例。其中大多数（58.3%）是由患者的亲属提出的。这些营养问题大多为低严重程度（56.2%），23.6%为严重程度，20.2%为非常严重程度。对 18 份非常严重的营养投诉的阅读显示，在 6 例病例中，营养问题引发了一系列问题。此外，我们发现两个高严重程度的营养问题导致了灾难性的伤害。
营养问题的比例较低可能表示对医院营养的低估。患者的阈值可能不会因营养不佳而超过，因此不会提出投诉。然而，投诉包含了有助于更广泛学习的重要见解，因为医院迄今为止的改进是基于临床医生的报告，而忽略了患者的观点。
