背景:医疗不良事件(HAE)报告框架不仅仅是一个工具。它是我们追求患者安全的重要支柱,质量改进,信任维护,法规遵从性,和医疗服务的道德标准。
目的:通过开展满意度调查,评估农村公立医院急诊科医护人员对HAE报告框架和此类报告管理方法的满意度。
方法:这项前瞻性观察性研究是在北方邦医科大学急诊医学系进行的,赛法伊,和毗邻的地区医院,从2023年11月到2024年1月。该研究涉及320名在急诊科工作的医疗保健专业人员。定量调查研究使用了问卷和Likert质量量表。使用非参数统计方法在序数测量量表上分析数据。使用频率表分析样本数据,百分比饼图,和比较条形图。在非参数统计检验中,单样本Wilcoxon符号秩检验用于推断人口的集中趋势,Kruskal-Wallis检验被用来推断人口类别。
结果:医疗保健专业人员对HAE报告框架和管理方法的满意度是多种多样的。在对急诊科的HAE报告框架进行调查时,在320名医疗保健专业人员中,50%(161)表示不满,47%(149)满意,3%(10)没有发表评论。护理人员最不满意(133人中的61%)。当被问及处理此类报告时的管理方法时,50%(159)满意,46%(147)不满意,4%(14)没有发表评论。在比较职业时,33名医生中有43%(29)和133名护理人员中有62%(83)不满意,给出一个糟糕的反应。此外,119名护理人员中61%(72)满意。非参数推理测试得出的两个问题的p值都小于0.001,表明人群对HAE报告框架和管理方法的反应存在显著差异。在成对比较中,职业组之间的感知存在显着差异(p<0.001),除了HAE报告框架中的医生和护理人员(p=0.638)。
结论:通过鼓励报告,标准化流程,彻底分析事件,并使用数据驱动的见解来为改进工作提供信息,医疗保健组织可以提高患者安全,提高护理质量,预防未来的不良事件。HAE报告的管理方法包括培养安全和透明的文化,实施标准化报告系统,为医护人员提供教育和培训,建立反馈机制,对报告的事件进行稳健分析,推动持续改进,并确保透明度和问责制。
BACKGROUND: The healthcare adverse event (HAE) reporting framework is more than just a tool. It is a crucial pillar in our pursuit of patient safety, quality improvement, trust maintenance, regulatory compliance, and ethical standards in healthcare delivery.
OBJECTIVE: To assess healthcare workers\' satisfaction with the HAE reporting framework and the management approach towards such reporting in the emergency department of rural government hospitals by conducting a satisfaction survey.
METHODS: This prospective observational research was conducted in the Department of Emergency Medicine of the Uttar Pradesh University of Medical Sciences, Saifai, and adjoining district hospitals from November 2023 to January 2024. The study involved 320 healthcare professionals working in the emergency department. The quantitative survey research used a questionnaire and a quality Likert scale response. The data were analyzed on an ordinal measurement scale using
nonparametric statistical methods. The sample data were analyzed using frequency tables, percentage pie charts, and comparison bar graphs. In
nonparametric statistical tests, the one-sample Wilcoxon signed rank test was used to infer the population\'s central tendency, and the Kruskal-Wallis test was used to make inferences about the population categories.
RESULTS: The satisfaction of healthcare professionals with the HAE reporting framework and the management approach was diverse. When surveyed about the HAE reporting framework in the emergency department, out of the 320 healthcare professionals, 50% (161) expressed dissatisfaction, 47% (149) were satisfied, and 3% (10) did not comment. Paramedics were most dissatisfied (61% of 133). When asked about the management approach while dealing with such reporting, 50% (159) were satisfied, 46% (147) were unsatisfied, and 4% (14) did not comment. On comparing professions, 43% (29) of 33 doctors and 62% (83) of 133 paramedics were unsatisfied, giving a poor response. Additionally, 61% (72) of the 119 nursing staff were satisfied. The non-parametric inferential tests yielded a p-value of less than 0.001 for both questions, indicating a notable difference in the population\'s response to the HAE reporting framework and management approach. On pairwise comparison, there was a significant difference in perception (p<0.001) between the occupation groups, except for doctors and paramedics (p = 0.638) in the HAE reporting framework.
CONCLUSIONS: By encouraging reporting, standardizing processes, analyzing incidents thoroughly, and using data-driven insights to inform improvement efforts, healthcare organizations can enhance patient safety, improve quality of care, and prevent future adverse events. The management approach to HAE reporting involves fostering a culture of safety and transparency, implementing standardized reporting systems, providing education and training to healthcare staff, establishing feedback mechanisms, conducting robust analysis of reported events, promoting continuous improvement, and ensuring transparency and accountability.