医師の認識,報告の準備,障害のある,無能な同僚に関連する経験
Catherine M DesRoches1, Sowmya R Rao, John A Fromson
1Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St, Ste 900, Boston, MA 02114, USA. cdesroches@partners.org
JAMA
|July 15, 2010
まとめ
医師は,障害のあるまたは無能な同僚を報告することに同意しますが,しばしば行動しません. 障壁には,他者が報告したり,報復を恐れたりすると考えられ,患者の安全に影響を及ぼします.
科学分野:
- 医療のプロフェッショナリズム
- 医者のパフォーマンスについて
- 医療の品質保証 医療の品質保証について
背景:
- ピア・モニタリングは,医師の障害や無能さを特定するために不可欠です.
- 既存のデータは,そのような問題の報告が不足していることを示しています.
- 医師の自己規制は,医療実践の礎石である.
研究 の 目的:
- 障害のある,または無能な同僚に対する医師の態度,準備,および経験を調査する.
- 医療実践に関する懸念事項の報告に影響を与える要因を特定する.
- 専門的なコミットメントと実際の報告行動の間のギャップを理解する.
主な方法:
- 米国における様々な専門分野における2938人の医師を対象とした全国的に代表的な調査です.
- 障害のある/無能な同僚との信念,準備,経験について収集されたデータ.
- 報告率と報告しない理由の分析.
主要な成果:
- 64%の医師が,障害のある/無能な同僚を報告するというコミットメントを支持しています.
- 障害のある同僚を扱う準備ができていると感じているのは69%で,無能な同僚を扱う準備ができているのは64%です.
- 17%が無能な同僚を知っており,67%がそれを報告し,過小評価されているマイノリティは報告する可能性が低い.
結論:
- 医師は報告の義務を認めるが,報告率は最適以下である.
- 他人が行動するだろうという信念や報復の恐れは,行動しないことの重要な理由です.
- これらの障壁を克服することは,患者の安全と医療の質を改善するために不可欠です.
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