Incident reports involving hospital administrative staff: analysis of data from the Japan Council for Quality Health care nationwide database

Abstract

Background Task shifting and task sharing in health care are rapidly becoming more common as the shortage of physicians increases. However, research has not yet examined the changing roles of hospital administrative staff. This study clarified: (1) the adverse incidents caused by hospital administrative staff, and the direct and indirect impact of these incidents on patient care; and (2) the incidents that directly involved hospital administrative staff. Methods This study used case report data from the Japan Council for Quality Health care collected from April 1, 2010 to March 31, 2019, including a total of 30,823 reports. In April 2020, only the 88 self-reported incidents by hospital administrative staff were downloaded, excluding incidents reported by those in medical and co-medical occupations. Data from three reports implicating pharmacists were rejected and the quantitative and textual data from the remaining 85 case reports were analyzed in terms of whether they impacted patient care directly or indirectly. Results Thirty-nine reports (45.9%) involved direct impact on patient care, while 46 (54.1%) involved indirect impact on patient care. Most incidents that directly impacted patient care involved administrative staff writing prescriptions on behalf of a doctor (n = 24, 61.5%); followed by errors related to system administration, information, and documentation (n = 7, 17.9%). Most reported errors that indirectly affected patient care were related to system administration, information, and documentation used by administrative staff (n = 22, 47.8%), or to reception (n = 9, 19.6%). Almost all errors occurred during weekdays. Most frequent incidents involved outpatients (n = 23, 27.1%), or occurred next to examination/operation rooms (n = 12, 14.1%). Further, a total of 14 cases (16.5%) involved patient misidentification. Conclusions Incidents involving hospital administrative staff, the most common of which are medication errors from incorrect prescriptions, can lead to severe consequences for patients. Given that administrative staff now form a part of medical treatment teams, improvements in patient care may require further submission and review of incident reports involving administrative staff.

Reported Incidents Involving Non-medical Care Workers and Nursery Teachers in Hospitals in Japan: An Analysis of the Japan Council for Quality Health Care Nationwide Database

“…We are not aware of the reasons for the small number of non-medical incident reports. However, a previous study using the JCQHC data reported that the number of reports from hospital administrative staff was small, and this trend was similar between hospitals [ 16 ]. Incident reporting research has focused on medical staff, such as physicians, nurses, and pharmacists.…”

“…The analysis was conducted by two researchers with a registered nurse qualification, one of whom also had a patient safety qualification and experience in content analysis. Textual data were analysed focusing on factors regarding the “what” and “why” of the reported incident, according to a previous study [ 16 ]. The two researchers analysed the data independently and then compared the identified contents to cross-check their validity.…”

“…Little attention has been paid to the impact of such task shifting on patient safety in hospitals. Although Akiyama et al reported that task shifting from physicians to hospital administrative staff led to cases of drug errors for patients, most previous studies on incident reports have focused on incidents involving clinical staff such as physicians, nurses, and pharmacists, who are qualified medical specialists, educated before being assigned work [ 16 ]. There is a dearth of research on patient safety and non-medical care workers, and nursery teachers directly involved in patient care.…”

Monitoring the Use of Personal Protective Equipment on Employers’ Health and Safety

“…For this reason, the use of personal protective equipment is very important in the prevention of work accidents. Work accidents can happen to every worker in doing work, because a work accident is an event or event that is undesirable to humans, damages property, or losses to the process in a job (Akiyama et al, 2020).…”

Dimension of Patient Safety Culture

“…Safety incidents that occur only at the beginner level are not done at the advanced level. The implications of this study are important as a reference to develop a new education system for nursing training in the workplace (Akiyama et al, 2020).…”