Abstract
It has been two and a half years since the enactment of medical accident investigation system, and a year since the enforcement, but the understanding of the system and the response of medical institutions and healthcare workers seems insufficient and only 388 incidents have been reported. Insufficient understanding on this system, avoiding commitment while understanding the purpose and value of this system, and guidelines published by healthcare organizations and research groups whose contents are not accordant to regulations might result in confusion and under-reporting. In either case, however, healthcare organizations are requested to follow the regulations.
In this paper, guidelines published by healthcare organizations and research groups were compared to identify the difference of reporting criteria of medical accidents in this system. Eleven guidelines published by healthcare organizations and research groups after the promulgation were examined as for the reporting criteria；‘patient's death caused by medical service’ and ‘unexpected patient's death. We examined the consistency with laws and regulations to compare the way of thinking or the criteria regarding ‘patient's death caused by medical service’ and ‘unexpected patient's death’. In medical institutions and healthcare workers, a uniform decision making for specifying a case which should be reported might be difficult, and it is often needed to determine case by case. As for the boundary cases, it might be needed to accumulate cases to determine whether a case is to be reported or not. To standardize the reporting criteria among guidelines of healthcare organizations and research groups seems effective in minimizing confusion in clinical practice and strengthen the reliability of this system. Appropriate response to this newly introduced system is essential in promoting reliability, patient safety and quality in healthcare.
