There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs.We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data.Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125).The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.
The possible association of patient safety events (PSEs) with the costs and utilization remains a concern. In this retrospective analysis, we investigated adult hospitalizations at a medical center between 2010 and 2015 with or without reported PSEs. Administrative and claims data were analyzed to compare the costs and length of stay (LOS) between cases with and without PSEs of the three most common categories during the first 14 days of hospitalization. Two models, including linear regression and propensity score-matched comparison, were performed for each reference day group of hospitalizations. Of 14,181 PSEs from 424,635 hospitalizations, 69.8% were near miss or no-harm events. Costs and LOS were similar between fall cases and controls in all of the 14 reference days. In contrast, for cases of tube and line events and controls, there were consistent differences in costs and LOS in the majority of the reference days (86% and 57%, respectively). Consistent differences were less frequently seen for medication events and control events (36% and 43%, respectively). Our study approach of comparing cases with PSEs and those without any PSE showed significant differences in costs and LOS for tube and line events, and medication events. No difference in cost or LOS was found regarding fall events. Further studies exploring adjustments for event risks and harm-oriented analysis are warranted.
Raw Datasets for the study 'In-hospital patient safety events, healthcare costs and utilization: an analysis of data from the incident reporting system in an academic medical center'.
Raw Datasets for the study 'In-hospital patient safety events, healthcare costs and utilization: an analysis of data from the incident reporting system in an academic medical center'.
Purpose: This paper describes our experience in integrating a patient safety and quality improvement program into the undergraduate medical education curriculum. Methods: We designed a 1-credit elective learning course, which integrates patient safety concept, quality management, and tools for continuous quality improvement (CQI), for fourth-year (pre-clerkship) medical students. Both classroom lectures and case-based interactive discussion activities on a case-scenario were taught in this learning course. We also made a website for facilitating learning or inquiry from students. A formative questionnaire to evaluate knowledge, skill, and attitude toward CQI as well as satisfaction to this learning course, was constructed. Results: Students' perception of knowledge and skill handling patient safety issues after this course were appropriate, with the former slightly higher than the latter. All students expressed a strong positive feedback to this course and will recommend this course to their colleagues and other students. In addition, teachers who participated in this course felt great fulfillment from interacting with students. Conclusion: Our program serving as an example of integrating patient safety and quality improvement program into undergraduate medical students is an effective way to expose future healthcare personnel earlier to the correct way of solving or dealing with patient safety issues.
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