Relating Medical Errors to Medical Specialties: A Mixed Analysis Based on Litigation Documents and Qualitative Data

Area of Science:

• Medical Law and Ethics
• Healthcare Management
• Patient Safety

Background:

• Medical errors are a significant concern, with existing knowledge on causes and prevention, but a gap remains in understanding their relationship with medical specialties.
• Effective prevention strategies require a deeper understanding of error distribution across different medical fields.

Purpose of the Study:

• To categorize and map the distribution of medical errors within various medical specialties.
• To analyze the specific relationships between types of medical errors and their corresponding medical departments.

Main Methods:

• Systematic random sampling of 5237 medical litigations from "China Judgment Online" based on keywords related to medical errors.
• Independent review by physicians to identify and categorize medical errors and their departments, with a third physician resolving discrepancies.
• Descriptive statistical analysis, mind mapping, and semi-structured interviews with 63 doctors to explore error-specialty relationships.

Main Results:

• Over 97.8% of medical errors occurred in clinical departments, with insufficient informed consent implementation being the most frequent error across internal medicine, surgery, and specialist departments.
• Error types correlated with specialties: surgical errors in surgical departments, diagnostic errors in internal medicine, and therapeutic errors in specialist departments.
• Contributing factors include lack of clinical experience, poor work system design, inadequate staffing, and unreasonable shift systems leading to increased workload and error rates.

Conclusions:

• Medical departments face both humanistic and technological errors, with insufficient communication, informed consent, privacy violations, and overtreatment being key humanistic concerns.
• Enhancing clinical skills and vigilance of medical staff is crucial for error reduction.
• Improving systemic issues, such as work design and resource allocation, is essential for medical institutions to mitigate medical errors.