描述涉及急诊部先进实践提供者,正在接受培训的医生和主治医生的医疗失误案件
Peter S Antkowiak1, Shin-Yi Lai1, Ryan C Burke1
1Department of Emergency Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA.
概括
先进实践提供者 (APP) 和实习人员占不当行为案件的21%和赔偿金的33%. 了解这些不当行为索赔可以帮助减轻在紧急情况下的提供者风险.
科学领域:
- 医疗不当行为 医疗不当行为
- 医疗保健经济学 医疗保健经济学
- 紧急医疗 紧急医疗
背景情况:
- 医疗错误索赔在医疗保健中构成重大财务和专业负担.
- 高级实践提供者 (APP),包括执业护士 (NP) 和医生助理 (PA),在患者护理中发挥着越来越重要的作用.
- 了解涉及APP和实习人员的不当行为索赔的特点和成本对于降低风险至关重要.
研究的目的:
- 评估涉及APP (NP和PA),实习生和主治医生的医疗不当案件的特点和财务成本.
- 在紧急部门的不同类型的提供者之间比较导致因素和索赔的严重程度.
主要方法:
- 从2010年1月1日到2019年12月31日期间,从Candello数据库中对不当行为索赔的回顾性分析.
- 索赔按提供者类型分类:NP,PA,实习生或"没有扩展者" (没有实质性的APP参与的案件).
- 分析包括支付的总赔偿金,促成因素 (临床判断,文档,监督) 和病例严重程度.
主要成果:
- 总共有5854个案件导致支付的总赔偿金超过10亿美元.
- APP和实习生案件占索赔的21%和总赔偿金的33%.
- 实习生案件的平均赔偿金最高,而"无延长者"案件的平均赔偿金最低. 与"没有扩展者"病例相比,NP和PA病例在临床判断和监督等贡献因素中显示出显著的差异.
- 与"没有扩展器"病例相比,涉及NP和PA的高严重性结局 (例如,肢体损失,死亡) 的百分比较低.
结论:
- 应用程序和实习人员参与了大量的医疗失职案件和紧急部门相关的财务成本.
- 声明特征的差异,如临床判断,文档和监督,突出了针对性风险管理策略的具体领域.
- 了解这些差异对于开发有效的干预措施来减轻提供者风险和提高紧急护理环境中的患者安全至关重要.
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