[Learning from Errors: Qualitative Analysis of Expert Reports on Malpractice in Family Medicine].

IF 0.7 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Gesundheitswesen Pub Date : 2024-04-01 Epub Date: 2023-07-14 DOI:10.1055/a-2098-3436

Christian Förster, Gernot Lorenz, Marko Wilke, Manfred Eissler, Stefanie Joos, Roland Koch

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引用次数: 0

Abstract

Background: Expert committees of the German medical associations provide a free and out-of-court evaluation of putative cases of medical malpractice. They prepare reports that contain valuable information on process steps that precede the actual treatment error. The aim of the present study was to identify and systematically categorize individual process steps in the expert reports and thus to lay the foundations for the understanding of malpractice evaluation processes.

Methods: In this study, ten randomly selected and anonymized expert reports of the Expert Committee for Questions of Medical Liability of the District Medical Association of South Württemberg with identified GP treatment errors were evaluated, using the method of qualitative content analysis. In an iterative process, central elements of expert reports were classified into a deductively and inductively built category system.

Results: Six main categories with associated subcategories were identified: 1) structural aspects of the report, 2) doctor-patient communication, 3) medical course, 4) patient's experience, 5) action by the GP team, and 6) coordinative role in the health care system. The category system showed sufficient reliability with repeated use.

Conclusion: This study offers an opportunity to learn from errors. The proposed system allows to structure the complexity of expert reports on GP malpractice and may thus serve as a tool in various contexts. In particular, it facilitates the preparation and comparative analysis of reports in a structured way. It could also be used in health care research as well as in education and training.

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[从错误中学习：对家庭医疗事故专家报告的定性分析]。

背景：德国医疗协会的专家委员会为医疗事故推定案件提供免费的庭外评估。他们编写的报告中包含了有关实际治疗错误之前的过程步骤的宝贵信息。本研究的目的是对专家报告中的各个过程步骤进行识别和系统分类，从而为了解医疗事故评估过程奠定基础：本研究采用定性内容分析的方法，对南符腾堡州地区医疗协会医疗责任问题专家委员会随机抽取的十份匿名专家报告进行了评估，其中包含已确认的全科医生治疗失误。在一个反复的过程中，专家报告的中心内容被归入一个演绎和归纳的类别系统：结果：确定了六个主要类别及相关子类别：1) 报告的结构方面；2) 医患沟通；3) 医疗过程；4) 患者体验；5) 全科医生团队的行动；6) 在医疗系统中的协调作用。经过反复使用，分类系统显示出足够的可靠性：本研究提供了一个从错误中学习的机会。所提议的系统可使有关全科医生渎职行为的专家报告结构更加复杂，因此可在各种情况下作为一种工具。特别是，它有助于以结构化的方式编写报告并对其进行比较分析。它还可用于医疗保健研究以及教育和培训。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gesundheitswesen PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

1.90

自引率

18.20%

发文量

308

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