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Sistemas de informes y divulgación de errores: puntos de vista de los líderes del hospital
Joel S Weissman1, Catherine L Annas, Arnold M Epstein
1Institute for Health Policy, Massachusetts General Hospital, Boston 02114, USA. jweissman@partners.org
JAMA
|March 17, 2005
Resumen
Los líderes de los hospitales temen que los sistemas de notificación obligatoria aumenten las demandas y reduzcan la notificación de errores internos, lo que afectará la seguridad del paciente. Son más propensos a reportar lesiones graves al estado que lesiones menores.
Área de la Ciencia:
- La política de salud de la política de salud.
- La investigación de la seguridad del paciente.
- Servicios de salud investigación servicios de salud.
Sus antecedentes:
- El Instituto de Medicina recomienda sistemas obligatorios de notificación de errores en el cuidado de la salud.
- Los sistemas de notificación obligatoria tienen como objetivo mejorar la seguridad del paciente y la rendición de cuentas.
Objetivo del estudio:
- Evaluar las perspectivas de los líderes de los hospitales sobre los sistemas estatales de notificación de errores.
- Comprender el impacto percibido de estos sistemas en la presentación de informes internos, litigios y seguridad del paciente.
Principales métodos:
- Se realizó una encuesta entre los directores ejecutivos (CEO) y directores de operaciones (COO) de los hospitales.
- Los hospitales fueron seleccionados de los estados con diferentes informes obligatorios y políticas de divulgación pública.
- Los encuestados evaluaron escenarios clínicos hipotéticos para medir la probabilidad de notificación.
Principales resultados:
- La mayoría de los líderes creían que los sistemas obligatorios y no confidenciales disuadirían a los informes internos y aumentarían las demandas.
- La mayoría de los líderes favorecieron la confidencialidad para los hospitales y los profesionales, aunque los estados de divulgación pública mostraron más voluntad de divulgar los nombres de los hospitales.
- Más del 90% reportaría lesiones graves de pacientes al estado, pero menos reportaría lesiones moderadas o leves.
Conclusiones:
- Los líderes de los hospitales expresaron preocupaciones significativas con respecto a los efectos de los sistemas de informes obligatorios y no confidenciales en los informes internos, los litigios y la seguridad del paciente.
- Si bien apoyan la divulgación de pacientes, los líderes están menos inclinados a reportar incidentes menos graves a los sistemas estatales.
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