Abstract
Health care does not always result in an outcome that patients expected. Furthermore, physicians are sometimes obligatory to make decisions without enough clinical evidence. In these situations, medical dispute may occur, and judgment about malpractice may sometimes be difficult to make by the hospital staff alone. Since the fiscal year 2004 the National Hospital Organization (NHO) Headquarters Kyushu Office has introduced expanded review boards regarding serious medical accidents, including professional specialists from outside the hospital investigating the cases. Professional specialists include physicians of the NHO Kyushu area hospitals who graduated from other medical schools than the one of the disputed physician, as well as co-medical staff such as nurses, pharmacists, physical therapists and medical engineers. In cases where no specialist from inside the NHO could be provided, professionals from outside the NHO hospitals were invited. Before getting the board started all participants review medical and nursing charts as well as imaging diagnostics, specify the problems and prepare up-to-date resources regarding the case. The issues are strictly discussed in the light of both medical and legal aspects. Many disputed cases could be resolved after honestly informing the parties involved about the conclusions of the board. In addition background, cause and prevention strategy of an accident are afterwards disclosed by the board to representatives of the NHO Kyushu area hospitals in a series of education programs. Such efforts have actually reduced the number of disputed cases.
