Benefit of doctors' assistant on medical safety

Abstract

The purpose of Medical Doctors' Assistant (DA) is to provide qualified medical care by reducing physicians' work load, expecting that they can contribute to enhance the quality of health care. However, little evidence is known if DA can indeed improve the quality of health care. The present study investigated if employing DA improved medical safety at the University Hospital using the incident reports filed by the medical doctors (MDs).

The number of incidents filed by MDs in the departments where DA is yet to be introduced was significantly increased during the study period compared to control term (7.4+/-1.8 vs 4.3+/-1.8, P＜0.02). In contrast, following DA implementation, those from the departments employing DA did not increase, as compared to before DA employment (4.0+/-0.6 vs 5.4+/-1.0, NS). The frequency of the increase or decrease in the incident was significantly different between departments with DA and those without DA；increase in the number of incidents was observed in 89% and 17% in the departments without and with DA, respectively; whereas, reduction in the number of incident was identified in 0% and 55% in those without and with DA, respectively (P＜0.02). Moreover, the incidents associated with doctors' hastiness, panic, and shortage of sleep decreased in the department with DA following introduction of DA, whereas they remained the same in those lacking DA before and after evaluation period. Moreover, the number of serious incident (over 3b) was significantly elevated in the department without DA (P＜0.05), but in contrast, it stayed the same in the department with DA, suggesting that DA prevented the serious incident from occurring. These data indicate that DA contributes to the medical safety by reducing the incidents that are involved in medical doctors.