記述言語：英語   出版者・発行元：BMC Anesthesiology  

Background: Informed consent with video assistance provides patients with standardized information regarding complex clinical procedures. We explored the potential of completely replacing conventional face-to-face informed consent processes involving written documents with videos for informed consent (VIC) in the context of anesthesia. Methods: A legally satisfactory VIC was developed to provide standardized information to patients and facilitate their understanding of anesthetic procedures, including their risks, benefits, and alternatives. In this single-center retrospective study, informed consent process-related data were extracted from two patient groups who underwent conventional informed consent and VIC. The opinions of the anesthesiologists were collected to evaluate workflow efficiency before and after VIC introduction. Statistical comparisons were performed using the Mann–Whitney U test. Results: Before VIC implementation, bedside IC required a median total time of 45 [30–60] min, including 10 [5–10] min of travel time and 35 [25–50] min for anesthesia explanation. After VIC adoption, bedside IC was completely eliminated, and the median duration for outpatient IC decreased to 21 [14–30] min for conventional IC and 17 [12–22] min for VIC (p < 0.001). Approximately 97% of patients reported that VIC aided them in obtaining an explanation of the anesthesia, and 94% of patients who received VIC sufficiently understood the content of the informed consent. After the VIC introduction, 80% of patients reported that they would choose an outpatient clinic with a VIC over a conventional informed consent if given the option. Before and after 6 months of adopting VIC, 53% and 69% of anesthesiologists felt favorably about VIC, increasing to 86% after one year of VIC adoption. Conclusions: VIC introduction successfully redistributed anesthesiologists’ workload and eliminated the need for bedside IC, while maintaining patient comprehension and satisfaction. These findings suggest that the standardized, repetitive components of the informed consent process are suitable candidates for digital transformation.

DOI： 10.1186/s12871-025-03536-7

Open Access

Web of Science

Scopus

PubMed

記述言語：英語   出版者・発行元：BMJ Health and Care Informatics  

Objectives Incident reporting systems are widely used to identify risks and enable organisational learning. Free-text descriptions contain important information about factors associated with incidents. This study aimed to develop error scores by extracting information about the presence of error factors in incidents using an original decision-making model that partly relies on natural language processing techniques. Methods We retrospectively analysed free-text data from reports of incidents between January 2012 and December 2022 from Nagoya University Hospital, Japan. The sample data were randomly allocated to equal-sized training and validation datasets. We conducted morphological analysis on free text to segment terms from sentences in the training dataset. We calculated error scores for terms, individual reports and reports from staff groups according to report volume size and compared these with conventional classifications by patient safety experts. We also calculated accuracy, recall, precision and F-score values from the proposed ‘report error score’. Results Overall, 114 013 reports were included. We calculated 36 131 ‘term error scores’ from the 57 006 reports in the training dataset. There was a significant difference in error scores between reports of incidents categorised by experts as arising from errors (p<0.001, d=0.73 (large)) and other incidents. The accuracy, recall, precision and F-score values were 0.8, 0.82, 0.85 and 0.84, respectively. Group error scores were positively associated with expert ratings (correlation coefficient, 0.66; 95% CI 0.54 to 0.75, p<0.001) for all departments. Conclusion Our error scoring system could provide insights to improve patient safety using aggregated incident report data.

DOI： 10.1136/bmjhci-2023-100935

Web of Science

Scopus

PubMed

記述言語：日本語   出版者・発行元：一般社団法人 日本臨床救急医学会  

<p><b>目的</b>：ICUでの内服薬投与は，経鼻胃管チューブでの投与が多く，薬剤によってはチューブ閉塞を起こしやすい。閉塞によるチューブの入れ替えは，患者および医療者の負担が大きい。そこで，過去に発生したインシデント事例および経管投与時に注意すべき薬剤を調査した。<b>方法</b>：2018年1月〜2020年7月の全病棟での閉塞事例，および2020年1月〜2020年6月にICUで使用した内服薬の製剤学的特徴を調査した。調査に基づきICUにおける薬剤の経管投与方法を標準化した。<b>結果</b>：過去の閉塞事例の原因は，酸化マグネシウム（9/31件）や複数薬剤の同時投与による閉塞（7/31件）などであった。他剤に影響する内服薬は，キレート形成する電解質製剤や溶解性を悪化させるシロップ剤などであった。調査結果より，一覧表を作成した。<b>結論</b>：看護師の投与手技の標準化や薬剤師の一覧表を用いた疑義照会が可能となり，ICUでのチューブ閉塞が減少している。標準化による新たな問題点を抽出し，今後の改善へつなげたい。 </p>

DOI： 10.11240/jsem.26.694

CiNii Research

記述言語：英語   出版者・発行元：Journal of Medical Systems  

Incident reporting systems have been widely adopted to collect information about patient safety incidents. Much of the value of incident reports lies in the free-text section. Computer processing of semantic information may be helpful to analyze this. We developed a novel scoring system for decision making to assess the severity of incidents using the semantic characteristics of the text in incident reports, and compared its results with experts’ opinions. We retrospectively analyzed free-text data from incident reports from January 2012 to September 2021 at Nagoya University Hospital, Aichi, Japan. The sample was allocated to training and validation datasets using the hold-out method. Morphological analysis was used to segment terms in the training dataset. We calculated a severity term score, a severity report score and severity group score, by report volume size, and compared these with conventional severity classifications by patient safety experts and reporters. We allocated 96,082 incident reports into two groups. We calculated 1,802 severity term scores from the 48,041 reports in the training dataset. There was a significant difference in severity report score between reports categorized as severe and not severe by experts (95% confidence interval [CI] −0.83 to −0.80, p < 0.001, d = 0.81). Severity group scores were positively associated with severity ratings from experts and reporters (correlation coefficients 0.73 [95% CI 0.63–0.80, p < 0.001] and 0.79 [95% CI 0.71–0.85, p < 0.001]) for all departments. Our severity scoring system could therefore contribute to better organizational patient safety.

DOI： 10.1007/s10916-022-01893-1

Web of Science

Scopus

PubMed

掲載種別：研究論文（学術雑誌）  

総ページ数：222   記述言語：日本語 著書種別：学術書

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