[不良事件调查的保密性-现状和需要]。

Harefuah Pub Date : 2022-11-01
Yaron Niv, Ilia Kagan, Dana Arad, Riki Avrahami, Yossi Tal
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引用次数: 0

摘要

简介:医务人员的目标是为病人提供适当、有效和高效率的治疗,并照顾他的健康。如果护理人员没有满足合理医生对合理护理的要求,也没有根据所掌握的信息在提供治疗时采取必要的预防措施,则导致严重后果或死亡的医疗差错可被视为疏忽。多年来,由于医疗失误对病人造成伤害而对其进行惩罚和赔偿的观念发生了巨大变化。根据汉谟拉比法,以直接和严厉的惩罚开始,以在一些国家广泛接受的“无过错”方法结束。在医疗过程中发生不良事件后,应通过回答4个问题进行流程,以吸取教训,减少未来类似事件再次发生的可能性:发生了什么?这是怎么发生的?为什么会这样呢?应该做些什么来防止将来发生类似的事件?《患者权利法》没有规定进行安全调查,但建议在治疗疏忽或错误的情况下成立检查委员会。根据法律,检查委员会的记录是保密的,如果记录中载有不太可能在医疗记录中找到的重要证据,法院可以将其删除。由于缺乏保密性,医务人员可能不愿进行安全调查,因为他们害怕将调查结果用于诉讼或任命一个检查委员会,其结论将报告给受害者及其家属。“无过错”方法克服了这些障碍,能够进行彻底的安全调查,对治疗的质量和安全具有重要的专业、经济和社会方面的影响。该方法扩大了受害者获得赔偿的机会,减少了索赔的数量和法院的负担。其他好处包括决策的透明度和一致性,由于医生愿意报告失败而促进患者安全,减少“防御性医疗”和卫生保健系统的支出。
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[CONFIDENTIALITY OF ADVERSE EVENTS INVESTIGATIONS - THE PRESENT STATUS AND WHAT IS NEEDED].

Introduction: The goal of the medical staff is to provide proper, effective and efficient treatment to the patient and to take care of his well-being. An error in medical care that causes a serious outcome or mortality, can be considered negligence when the caregiver did not meet the requirements of a reasonable physician for reasonable care and did not take the necessary precautions in providing the treatment, in light of the information available to him. The perception of punishment and compensation due to harm, caused to a patient as a result of a medical error, changed dramatically over the years. Starting with direct and severe punishment according to Hammurabi laws and ending with the "no fault" approach that is accepted widely in some countries. Following an adverse event that occurred in medical treatment, a process should be conducted in order to draw lessons to reduce the likelihood of recurrence of similar incidents in the future, by answering 4 questions: What happened? How did it happen? Why did it happen? and What should be done to prevent similar incidents in the future? The Patient Rights Act does not suggest conducting a safety investigation but recommends an examination board in cases of negligence or error in treatment. By law, the protocols of the examination board are confidential and can be removed by the court in case the protocol contains evidence of importance that is unlikely to be found in the medical record. Lack of confidentiality may cause medical staff to be reluctant of conducting a safety investigation due to fear of using its findings for a lawsuit or appointing an examination board whose conclusions will be reported to the victim and his family. The "no fault" method overcomes these barriers by enabling a thorough safety investigation and has important professional, economic and social aspects with a direct impact on the quality and safety of treatment. The method expands the accessibility of victims to compensation, reduces the number of claims and the burden on the courts. Among additional benefits are transparency and consistency in decisions, promoting patient safety due to physicians' willingness to report failures, reduction in "defensive medicine" and spending in the health care system.

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