Language：English   Publisher：Nagoya Journal of Medical Science  

Medical safety management has an economic dimension that has received little attention. Medical expenses associated with medical malpractice in Japan should be investigated in relation to patient safety measures and their consequences. We analyzed medical accidents that occurred within the past seven years at a university hospital. We determined that 197 accidents involved negligence by the hospital in the years from 2011 to 2017, for which the institution bore the costs of the resulting treatment; those expenses totaled JPY 30.547 million. Most incidents occurred in the hospital ward (82, 41.6%); those in the operating room were the most expensive (JPY 19.493 million, 63.8%). The greatest number of cases involved drug administration (63, 32.0%). Materials inadvertently left in surgical sites (“remnants”) cost the hospital the most per incident (JPY 9.767 million, 32.0%). Of these, medical treatment costs for remnants associated with vascular invasion were the highest. Although the total number of malpractice incidents increased over time, the annual cost to the hospital decreased, especially in cases in which costs exceeded JPY 100,000, and those associated with the operating room. Our results suggested that adverse events must be addressed to foster patient safety, decrease medical expenses, and improve hospital administrative capacity.

DOI： 10.18999/nagjms.83.3.397

Web of Science

Scopus

PubMed

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (other academic)  

Language：Japanese   Publisher：The Japanese Society for Quality and Safety in Healthcare  

Purpose: A pharmaceutical package insert is an only drug information based on the Japanese law. By revised rule of pharmaceutical package inserts and paperless movement, the digitization has been considered. However, it is unclear how doctors are checking pharmaceutical package inserts.

Methods: In January 2020, a questionnaire was provided to participants in the General Medicine In-Training Examination (GM-ITE).

Results: A total of 6,869 residents (539 hospitals) participated in the GM-ITE. Of these, we analyzed the responses of 5,468 residents who fully responded to the survey. 537 residents (9.8%) belonged to Special Functioning Hospitals, and 4,931 residents (90.2%) belonged to other hospitals. 1,749 (32.0%) residents responded that they checked all pharmaceutical package inserts they ordered, 3,497 (64.0%) checked them among high-risk drugs only, and 222 (4.1%) never checked. There was no significant difference between the status of checking pharmaceutical package inserts and the affiliation (p=0.20).

Discussion: This is the first nation-wide survey to investigate the status of checking pharmaceutical package inserts. Since some serious drug errors have occurred due to inadequate confirmation of the package insert, it is desirable to consider how to provide a practical package insert and to develop a method to disseminate and educate the public about the revised content.

DOI： 10.11397/jsqsh.16.454

CiNii Research

Language：Japanese   Publisher：一般社団法人 日本医療薬学会  

DOI： 10.20825/amjsphcs.30.0_321

CiNii Research

Language：English   Publisher：Nagoya Journal of Medical Science  

This study aimed to evaluate the efficacy of interventions to reduce patient misidentification incidents classified as level 2 and over (adverse events occurred for patients) with the step-by-step problem-solving method. All incidents related to patient misidentification were selected, and relevant information was collected from the original electronic incident reports. We then conducted an eight-step problem-solving process with the aim of reducing patient misclassification and improving patient safety. Step 1: the number of misidentification-related incident reports and the percentage of these reports in the total incident reports increased each year. Step 2: the most frequent misidentification type was sample collection tubes, followed by drug administration and hospital meals. Step 3: we set a target of an 20% decrease in patient misidentification cases classified as level 2 or over compared with the previous year, and established this as a hospital priority. Step 4: we found that discrepancies in patient identification procedures were the most important causes of misidentification. Step 5: we standardized the patient identification process to achieve an 10% reduction in misidentification. Step 6: we disseminated instructional videos to all staff members. Step 7: we confirmed there was an 18% reduction in level 2 and over patient misidentification compared with the previous year. Step 8: we intend to make additional effort to decrease misidentification of patients by a further 10%. Level 2 and over patient misidentification can be reduced by a patient identification policy using a step-by-step problem-solving procedure. This study aimed to evaluate the efficacy of interventions to reduce patient misidentification incidents with step-by-step problem-solving method. Continued seamless efforts to eliminate patient misidentification are mandatory for this activity.

DOI： 10.18999/nagjms.82.2.315

Web of Science

Scopus

PubMed

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (conference, symposium, etc.)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)