臺灣醫預法與國外醫糾處理及通報制度之比較

Abstract

目的：過去十多年以來，臺灣以鼓勵自願性通報(Taiwan Patient-safety Reporting system , TPR)作為提升病安文化的方式，在「醫療事故預防及爭議處理法」實施後，未來凡符合「重大醫療事故」定義者皆需進行法定通報，本文整理比較各國通報制度，作為臺灣實施之參考。結果：比較臺灣與各國之異同：臺灣病安通報發展模式與英國相近，先由自願性通報開始，發展至法定通報；澳洲由各地方政府自訂法定通報事項，其中Safer Care Victoria(SCV)的11類Sentinel Event (SE) 法定通報事件，可作為定義重大醫療事故(Never Events)時的參考，此外，澳洲由獨立單位負責根本原因分析調查，可作為臺灣推動之參考。結論：醫預法施行後仍需持續監測評估此一法定通報制度之成效，以達到預防及促進病人安全之目的。 Purpose: In Taiwan, over the past ten years, voluntary reporting (Taiwan Patient-safety Reporting system (TPR)) was encouraged as the strategy to improve the culture of patient safety. After the implementation of "" Medical Accident Prevention and Disputes Resolution Act"", any incidence meets the definition of ""Never Events"" will be subject to Mandatory Reporting System in the future. What will be the expected effects of changing this reporting system on improving medical quality and promoting patient safety? By comparing the reporting systems among countries will serve as the reference for Taiwan after implementation. Research methods: ""Document analysis"" and ""comparative study"" will be applied for this article. Result: To compare the discrepancy between Taiwan and the other countries, refer to the following: The development of Taiwan’s patient safety reporting system is similar to the model of the United Kingdom, gradually developing from voluntary to mandatory reporting; in Australia, local governments can define their own items for mandatory reporting, among which the 11 types of mandatory reporting Sentinel Event (SE) of Safer Care Victoria (SCV) can be used as the reference for the definition of Never Events, in addition, Australia has an independent unit responsible for Root Cause Analysis (RCA), which can be also used as the reference for Taiwan to promote RCA after the implementation of Medical Accident Prevention and Disputes Resolution Act. Conclusion: After the official implementation of Medical Accident Prevention and Disputes Resolution Act, it is necessary to continuously monitor and evaluate the effectiveness of this Mandatory Reporting system to establish the culture of patient safety in our country.