Identifying Hierarchical Structure of Factors Contributing to Medical Errors and Occasional Tendency of Causal Attribution

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  • 医療エラーの寄与因子の階層構造および原因帰属の職系別傾向の特定
  • イリョウ エラー ノ キヨ インシ ノ カイソウ コウゾウ オヨビ ゲンイン キゾク ノ ショクケイ ベツ ケイコウ ノ トクテイ

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Purpose: The analysis of incident reports is essential in preventing medical errors. However, the contributing factors in reporting systems are not standardized and do not reflect the subjective reality of perceptions by medical staff. Therefore, this study aims to develop a more comprehensive and systematic category of contributing factors based on the staff's perceptions, identify their factor structure and examine overall and occupational tends in the causal attribution of medical errors. <br> Subjects and Methods: We administered a questionnaire survey to all staff at an acute general hospital. <br> Results: We identified a hierarchical structure of three superordinate factors and seven subfactors. In addition, "external" and "cognitive" subfactors were positively associated with untreated and minor cases, while "social" was negatively associated with untreated cases and "organizational" with minor cases. However, the tendencies of causal attribution varied by occupational categories, and nurses were found to be more diverse and inhibitory than physicians in their attribution. <br> Discussion and Conclusion: Medical staff tended to attribute the cause of medical errors to their indiscretions or problems with patients or medical supplies, depending on occupational categories. However, this tendency is in danger of facilitating the occurrence of medical errors. Therefore, as an effective countermeasure, it is vital to instill a restrained mindset that does not easily blame oneself or others but attributes the cause to “social” and “organizational” factors.

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