Research On Incentive And Restraint Policy For Medical Adverse Event Reporting Of Hospitals

ObjectiveKnow about the knowledge of the medical adverse event reporting at home and abroad though the literature analysis,so as to establish the theoretical basis of this research. Through an investigation of the happening and reporting of medical adverse event to analyze the factors which can influence the reporting and the effection of the common restrained and restraint measures. The result of this research can provide suggestions to establish the restrained and restraint measures of the medical adverse event reporting. Thought these measures, the administrator of hospital can increase the rate of the medical adverse event reporting, so that the patients will be safer and the medical disputes will be less.MethodsThis research has been done using the literature retrieval and the field survey. We chose a three-level hospital in Hubei province and a two-level hospital in Anhui province, and then chose 280 medical officers by stratified sampling to participate the quesiongnaire survey. The question include the rate of the medical adverse event occurred, the reporting rate and the factor which influence the reporting. We get 267 questionnaires back and the back rate is 95.4%, 256 questionnaires are qualified and the qualified rate is 91.4%. All data derived from questionnaires is processed by SPSS software package(version 16.0) for descriptive analysis,χ2 analysis and Binary Logistic analysis. Conduct semi-structured interview For medical staffs ,management personnel and researchers ,so as to realize the status and problem of medical adverse event reporting.Results1. 7.0% of these medical staff have happened serious medical adverse events and 46.1% of them have happened slight medical adverse events, 35.2% of them have found their colleague causing the medical adverse events. That shows the happening of the medical adverse events is a serious problem and the result is the same to the previously researches.2. For their own medical adverse events, 58% medical staffs have a high reporting rate and 41.4% medical staffs have a low reporting rate. But to the others'medical adverse events, 28.9% medical staffs have a high reporting rate and 71.1% medical staffs have a low reporting rate. The chi-square test shows they have the statistically significant differences. That shows the medical staffs wound not report the others'medical adverse events. The position of the medical officer is an important factor to the reporting rate of their own and the others'medical adverse events.The title is higher,the reporting is worse.3. To the reporting willingness, 75.8% medical staffs chose reporting to the professor of the clinical section or the head nurse and then reporting to the leader of the hospital. 70.3% medical staffs will deal with the medical adverse event by themselves and don't report to anyone.4. Most of the medical staffs believed that if the reporting system is simpler and the administrators paid more attention to the events reporting, the reporting rate will be higher. To their own medical adverse events, 50% medical staffs fear of reporting because of medical disputes, economic compensation, losing job, losing promoting chance, revealing their identity and being blamed. And a part of medical staffs believed that reporting would result in dishonor, being despised by their colleague, or they did not know the reporting system well, and they suspicious their reporting would be utilized or not, however some of them did not have enough time to report the events. To the others'medical adverse events, 60% medical staffs supposed that their colleague would report by themselves so that there is no needing of reporting by me, some of medical staffs thought if they reporting the others'events they would be revenged, and there are no factors to promote their reporting.5. More than a half of medical staffs believed that they did not know the reporting system well, and about 20% medical staffs did not know the reporting system at all. 40.6% medical staffs believed that they can realize the happening of the medical adverse events in time, and 58.6% medical staffs supposed that they can realize the happening of events generally, however just 0.8% medical staffs thought they can not realize the happening of events in time.6. To the ways of reporting, most of medical staffs felt easy to report by information system or telephone. And they wished the reporting is voluntarily, anonymous and non-punishment. Most of medical staffs thought that both reward and punishment can improve the reporting rate, however they also thought the reward is fist but the punishment is second is a good idea. They whished the reward and punishment were expressed by career prospect.7. Medical Adverse Event Reporting existed some problems:1) The rate of Minor medical adverse event reporting was low;2) Reporting information was incomplete ;3) Multiple departments supervised reporting ;4) Reporting information was Lack of analysis and feedbackConclusion1. Educate medical staffs to report medical adverse events and hold lectures to make medical staffs understand the knowledge of medical adverse events.2. Constructing anonymous, the non-punishment reporting environment3. Carry out various of way to report medical adverse events,such as reporting information system,telephone,document and Email.4. Pay attention to analyze medical adverse events and feedback the results5. Establish the medical risk funds6. Pay close attention to minor medical adverse events reporting.For reporting medical adverse events,"the reward is fist but the punishment is second"or"the reward and the punishment in the same position". Spiritual reward, material reward and excellence award are adopt to encourage reporting, focusing on excellence award...