Abstract
Author(s): Anna Rej-Kietla (ABCDEF), Sandra Kryska (ABCD), StanisÅaw Horák (ABDEF), Marlena StÄpniak (BCDE), Tomasz Kulpok-BagiÅski (DEF), Jerzy Robert Åadny (DE), Klaudiusz Nadolny (BCDE), Daniel ÅlÄzak (EF)
Introduction. The dynamic development of medical sciences, growing awareness of patients’ rights and increasing influence of the media on the public opinion are potential sources of greater patient–physician tension. Aim. The article is aimed at evaluating the significance of the problem and, after a detailed analysis of complaints from 20 years, formulating guidelines which might be useful for reducing the number of adverse events and their consequences in the field of gynecology and obstetrics. Material and methods. The material used for the study was the data from 296 proceedings related to complaints about adverse events occurring in patients of outpatient healthcare centers and gynecology/obstetrics hospital departments in the years 1994–2014, selected out of 4,565 complaints in these areas. Results. The analysis demonstrated a growth in the number of complaints filed to the Regional Spokesperson for Professional Liability of Physicians (RSPLP) and an increasing rate of complaints related to gynecology and obstetrics, which was, however, characterized by a simultaneous decrease in their justifiability. In total, only 8.2% of the complaints were considered justified. The majority of the complaints concerned events taking place at the beginning of the week, but their rate of justifiability was the lowest. The complaints concerned usually events occurring in the afternoon or at night. Conclusions. It seems justified to introduce standard procedures using evidence-based medicine and an efficient obstetric data collection system, which should delimit the overlapping competences of physicians and midwives caring for the patient in the peri-delivery period. It seems justified to introduce examinations to check psychological predispositions of candidates to medical studies and trainings in stress management at work. It would be advisable to implement a system of mediation and maintaining contact of physicians and hospital representatives with patients and their families. It would also be helpful to introduce generally accessible information in healthcare centers, and to educate patients. Also, the introduction of work organization and staff-related solutions eliminating fatigue and discouragement seems to be reasonable.