The problem of waiting time at hospitals in Japan is the most worrisome problem from the viewpoint of improving patient satisfaction. At Shonan Kamakura General Hospital (Acute medical care category,658 beds), efforts were made to reduce complaints during outpatient waiting time using AIDET®, which is a patient treatment method. Patient complaints were divided into those that were expressed and those that were not. Complaints that are expressed are defined as “explicit complaints” (The evaluation method is “complaint occurrence rate”) and complaints that are not expressed are defined as “latent complaints” (The evaluation method is “stress index”). As changes before and after AIDET® education for staff, the transition of explicit complaints and latent complaints was evaluated by a patient questionnaire. The complaint occurrence rate and the stress index were Significantly reduced, and AIDET® was useful as a method. It is possible to allocate and shift the patient’s consciousness from waiting time to other fields by using patient treatment, and it is considered to be a measure to reduce complaints. AIDET® is considered to have the elements that cause such behavior.

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Objectives: To examine background factors that are characteristic of patient misidentification. Methods: The subjects were 247 patient misidentification cases reported from April 2017 through March 2020 and non-patient misidentification cases from April 2019 through March 2020. We focused on four background factors: time pressure, work interruption by concurrent or new task, presence of multiple objects on the same work table or task list, and same surname / similar name. The frequency of these background factors and of each combination of the background factors in the two groups, and the frequency of them by situations, type of occupation and years of experience in patient misidentification were examined. We examined whether the four background factors are characteristic of patient misidentification with logistic regression analysis in the cases reported from April 2019 through March 2020. Results: The frequency of these background factors was significantly higher in the patient misidentification cases compared to the non-patient misidentification cases, and not significantly different among each situation, type of occupation and years of experience. Multiple background factors were found in 57.9% of the misidentification cases, and the cases with time pressure and presence of multiple objects on the same work table or task list were the most frequently reported. At least one of these background factors were observed in 90.3% of patient misidentification. Same surname or similar name was not observed in non-patient misidentification, and then considered to be extremely characteristic of patient misidentification. The other three background factors were also significantly characteristic by logistic regression analysis, but the odds ratio for presence of multiple objects on the same work table or task list was the highest. Conclusions: The four background factors, especially same surname / similar name and presence of multiple objects on the same work table or task list, are characteristic of patient misidentification.

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Objective: The purpose is to identify the usefulness of the measurement as a factors of incident occurrence by measuring nurses' subjective scores of fatigue, sleep, and mood, prospectively and continuously over a period. Method: Nurses working at Hospital A were asked to fill out a survey during each of their shifts over a one-month period. On the first survey, participants provided information on their basic attributes. Subsequent surveys asked the nurses to indicate their incident experience and subjective feelings of fatigue, sleep, and mood at the beginning and end of each shift using a visual analog scale. Statistical analysis included t-tests, paired t-tests. Results: We analyzed 207 nurses in 17 departments. There was a significant difference (p = 0.015) between years of departmental experience and incident experience (mean, 3.31 years for those with experience and 4.42 years for those without). There was also a significant difference (p = 0.022) in fatigue at the beginning of the day shift (mean, 51.20 points for those with experience and 60.06 points for those without). Conclusions: It was suggested that measuring nurses' subjective scores of fatigue at the beginning of the day shift may be a predictor of the occurrence of incidents during this shift.

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The Maternal Safety Joint Project, in conjunction with The World Health Organization’s (WHO) World Patient Safety Day was launched to create a world in which no pregnant woman or newborn is harmed in healthcare. The project team consisted of maternal and neonatal care experts as well as safety and quality experts. The purpose was to develop strategies for remaining maternal safety issues in Japan. Following the WHO’s Global Patient Safety Action Plan 2021-2030, we discussed who needs to be in the team, what are our shared values, and what is our specific purpose for the upcoming ten years. We analyzed why adverse events in the perinatal period cannot be eliminated, from the perspective of patients, staff members, tasks and technology, teams, the work environment, society etc. Three achievable countermeasures for improvement were selected. First of all, we propose to promote shared decision-making with the pregnant women and families, with development of unified risk-sharing tools during the perinatal period. Secondly, clearly goal relating to peripartum emergencies needs to be established among all staff members, and the development of adequate quality indicators to measure better maternal care is required. The third countermeasure is the introduction of a simple reporting program for primary maternal care clinics and support from general hospitals beginning to be considered for improving the safety culture. These countermeasures would constitute the first step to assuring psychological safety among all the stakeholders.

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