Abstract
The purpose of this study was to describe the incidence and nature of adverse events (AEs) in obstetrics of "Incidence of adverse events in Japanese Hospitals: A National Survey" from the point of view of medical quality assurance, according to the retrospective chart review in some another countries. As a reason, there are a lot of lawsuits in obstetrics in Japan. In this study, an adverse event is defined as 1) an unintended injury or complication, 2) which resulted in temporary or permanent disability, and 3) which was caused by health care management rather than disease process. We analyzed 313 obstetric cases in the charts we randomly selected from inpatients discharged from 13 hospitals in fiscal year 2002. In the first stage review, nurse reviewers screened all the qualified charts and selected charts that satisfied one or more of 18 criteria to indicate a potential AE. In the second stage review, more than one physician reviewers reviewed the screened charts, identified AEs and assessed their preventability.
AEs were detected in 2.9% of obstetric admissions. The distinguishing characteristic of AEs in obstetrics was that almost all of them were judged difficult to prevent. But we could detect highly preventable AE's in which appropriate treatment for hemorrhage was not taken promptly. We suggest that the highly preventable event like this should be devised a proper countermeasure.
