Incident reporting among physicians‐in‐training in Japan: A national survey

Kurihara, Masaru; Nagao, Yoshimasa; Tokuda, Yasuharu

doi:10.1002/jgf2.454

Cited by 3 publications

(6 citation statements)

References 8 publications

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“…The data on falls in this study were derived from both the daily incident reporting system and reports specially created for the research purpose. However, the incidence of falls could have been underreported [ 38 , 39 ], which would have affected the results. In addition, the two hospitals had implemented comprehensive fall prevention measures [ 40 – 42 ] with established evidence in this study, even though many fall prevention measures lacked established evidence.…”

Section: Discussionmentioning

confidence: 99%

External validation of a new predictive model for falls among inpatients using the official Japanese ADL scale, Bedriddenness ranks: a double-centered prospective cohort study

et al. 2022

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Background Several reliable predictive models for falls have been reported, but are too complicated and time-consuming to evaluate. We recently developed a new predictive model using just eight easily-available parameters including the official Japanese activities of daily living scale, Bedriddenness ranks, from the Ministry of Health, Labour and Welfare. This model has not yet been prospectively validated. This study aims to prospectively validate our new predictive model for falls among inpatients admitted to two different hospitals. Methods A double-centered prospective cohort study was performed from October 1, 2018, to September 30, 2019 in an acute care hospital and a chronic care hospital. We analyzed data from all adult inpatients, for whom all data required by the predictive model were evaluated and recorded. The eight items required by the predictive model were age, gender, emergency admission, department of admission, use of hypnotic medications, previous falls, independence of eating, and Bedriddenness ranks. The main outcome is in-hospital falls among adult inpatients, and the model was assessed by area under the curve. Results A total of 3,551 adult participants were available, who experienced 125 falls (3.5%). The median age (interquartile range) was 78 (66–87) years, 1,701 (47.9%) were men, and the incidence of falls was 2.25 per 1,000 patient-days and 2.06 per 1,000 occupied bed days. The area under the curve of the model was 0.793 (95% confidence interval: 0.761–0.825). The cutoff value was set as − 2.18, making the specificity 90% with the positive predictive value and negative predictive value at 11.4% and 97%. Conclusions This double-centered prospective cohort external validation study showed that the new predictive model had excellent validity for falls among inpatients. This reliable and easy-to-use model is therefore recommended for prediction of falls among inpatients, to improve preventive interventions. Trial registration UMIN000040103 (2020/04/08)

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Section: Discussionmentioning

confidence: 99%

External validation of a new predictive model for falls among inpatients using the official Japanese ADL scale, Bedriddenness ranks: a double-centered prospective cohort study

et al. 2022

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“…This study was a nationwide, cross-sectional survey in Japan. Based on a previous study [13], we used a validated questionnaire on patient safety, which is to be completed at the end of the General Medicine In-Training Examination (GM-ITE). The GM-ITE, designed by a committee of the Japan Institute for Advancement of Medical Education Program (JAMEP), provides program directors with an objective and reliable assessment of a resident's fundamental clinical knowledge.…”

Section: Methodsmentioning

confidence: 99%

“…After the GM-ITE, the participants completed an optional questionnaire that assessed their residency training and work environment, including their incident reporting behavior. Both the original GM-ITE and the abovementioned questionnaire have been used in prior studies [13,15,16]. This study was approved by the Ethics committee of Japan Institute for Advancement of Medical Education Programme .…”

Section: Methodsmentioning

confidence: 99%

“…The questionnaire was developed following consensus among two investigators based on known incident reporting challenges in Japan (e.g., under-reporting and lack of knowledge on patient safety) [13]. First, the questionnaire asked participants about the total number of incidents they had encountered and the number of incidents they had reported in the previous year.…”

Section: Data Collectionmentioning

confidence: 99%

“…It has even been a basic requirement for the completion of residency training in Japan [10]. However, such educational interventions alone have been insufficient in significantly impacting patient safety practices [11][12][13][14]. In fact, despite these efforts, a recent survey showed that half of the resident physicians had not submitted an incident report in the past year, and more than half did not even know how to submit an incident report [13].…”

Section: Introductionmentioning

confidence: 99%

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Nationwide survey on Japanese residents’ experience with and barriers to incident reporting

et al. 2022

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The ability of any incident reporting system to improve patient care is dependent upon robust reporting practices. However, under-reporting is still a problem worldwide. We aimed to reveal the barriers experienced while reporting an incident through a nationwide survey in Japan. We conducted a cross-sectional survey. All first- and second-year residents who took the General Medicine In-Training Examination (GM-ITE) from February to March 2021 in Japan were selected for the study. The voluntary questionnaire asked participants regarding the number of safety incidents encountered and reported within the previous year and the barriers to reporting incidents. Demographics were obtained from the GM-ITE. The answers of respondents who indicated they had never previously reported an incident (non-reporting group) were compared to those of respondents who had reported at least one incident in the previous year (reporting group). Of 5810 respondents, the vast majority indicated they had encountered at least one safety incident in the past year (n = 4449, 76.5%). However, only 2724 (46.9%) had submitted an incident report. Under-reporting (more safety incidents compared to the number of reports) was evident in 1523 (26.2%) respondents. The most frequently mentioned barrier to reporting an incident was the time required to file the report (n = 2622, 45.1%). The barriers to incident reporting were significantly different between resident physicians who had previously reported and those who had never previously reported an incident. Our study revealed that resident physicians in Japan commonly encounter patient safety incidents but under-report them. Numerous perceived and experienced barriers to reporting remain, which should be addressed if incident reporting systems are to have an optimal impact on improving patient safety. Incident reporting is essential for improving patient safety in an institution, and this study recommends establishing appropriate interventions according to each learner’s barriers for reporting.

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Safety culture survey among medical residents in Japan: a nationwide cross-sectional study

Watari,

Kurihara,

Nishizaki

et al. 2023

BMJ Open Qual

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PurposeThis study aimed to examine safety culture among Japanese medical residents through a comparative analysis of university and community hospitals and an investigation of the factors related to safety culture.MethodThis nationwide cross-sectional study used a survey to assess first and second-year medical residents’ perception of safety culture. We adapted nine key items from the Safety Awareness Questionnaire to the Japanese training environment and healthcare system. Additionally, we explored specific factors relevant to safety culture, such as gender, year of graduation, age, number of emergency room duties per month, average number of admissions per day, incident experience, incident reporting experience, barriers to incident reporting and safety culture. We analysed the data using descriptive statistics and multivariate logistic regression analysis.ResultsWe included 5289 residents (88.6%) from community training hospitals and 679 residents (11.4%) from university hospitals. A comparative analysis of safety culture between the two groups on nine representative questions revealed that the percentage of residents who reported a positive atmosphere at their institution was significantly lower at university hospitals (81.7%) than at community hospitals (87.8%) (p<0.001). The other items were also significantly lower for university hospital residents. After adjusting for multivariate logistic analysis, university hospital training remained significantly and negatively associated with all nine safety culture items. Furthermore, we also found that university hospital residents perceived a significantly lower level of safety culture than community hospital residents.ImplicationsFurther research and discussion on medical professionals’ perception of safety culture in their institutions as well as other healthcare professionals’ experiences are necessary to identify possible explanations for our findings and develop strategies for improvement.

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Incident reporting among physicians‐in‐training in Japan: A national survey

Cited by 3 publications

References 8 publications

External validation of a new predictive model for falls among inpatients using the official Japanese ADL scale, Bedriddenness ranks: a double-centered prospective cohort study

External validation of a new predictive model for falls among inpatients using the official Japanese ADL scale, Bedriddenness ranks: a double-centered prospective cohort study

Nationwide survey on Japanese residents’ experience with and barriers to incident reporting

Safety culture survey among medical residents in Japan: a nationwide cross-sectional study

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