Safety management for Post-graduate clinical training

2005 Fiscal Year Final Research Report Summary

• Project/Area Number: 16390149
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Nagoya University
• Principal Investigator: TAKAHASHI Hideo Nagoya University, Graduate School of Medicine, Associate Professor, 大学院・医学系研究科, 助教授 (30291404)
• Co-Investigator(Kenkyū-buntansha): UEHARA Naruo Tohoku University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (80144286) ; KOIZUMI Shunzo Saga University Hospital, Professor, 医学部附属病院, 教授 (40274584) ; NAGASAKI Hiroshi Tohoku University, University Hospital, Research Associate, 医学部附属病院, 助手 (50332507)
• Project Period (FY): 2004 – 2005
• Keywords: Post-graduate Clinical training / Patient Safety / Safety Management / Simulation training

Research Abstract

An investigational survey using questionnaires clarifying the current situation of the safety management, the educational program concerning the patient safety, the working conditions during the residency program in Japan was conducted. 223 teaching hospitals (23.8% of all the teaching hospitals) responded to the survey and it was revealed that 1. educational systems, especially the quantities of the certified teachers are to be established. 2. educational tools and modules including the standardized contents of the curriculum, skills for the common procedures, simulation training are underdeveloped 3. the hospital fail-safe and back-up system in case of incidents/accidents are underdeveloped 4. The importance of the education about Patient Safety and additional curriculum are not completely recognized even among those teaching hospitals 5. Work load derived from the consecutive working hours over 8hrs tend to be underestimated. To improve these situations especially to establish an ad equate educational system, strategies to motivate the medical stuffs seem to be indispensable. To prevent incidents and assure the patient safety when residents perform invasive procedures, predictive risk analysis (PRA) was conducted for sub-clavian veni-puncture procedure and risks are summarized into spreadsheet. Based on the results, high risks that should be avoided are recognized and are categorized in terms of procedure, environment. An IT teaching material that enables residents to understand the apparent and latent risks easily on PC was developed. This IT material was tried among some teaching hospitals and highly reputated.
After visiting some top-level simulation centers in USA, the merits and demerits associated with the simulation training were summarized, and the Morbidity & Mortality conferences which could be a potent weapon to improve the hospital systems are experienced and from the educational standpoint, it was recognized that those M&M conferences wait to be commonly held in the teaching hospitals in Japan.