Presentation on theme: "Health Regulation Department (HRD)"— Presentation transcript:
1 Health Regulation Department (HRD) Investigation of Medical Complaint Dr. Layla Al Marzouqi Head of Clinical GovernanceHealth Regulation Department (HRD)
2 Medical ComplaintExpressions of dissatisfaction or concerns about a health care service made by consumers.All complaints & concerns are included, whether they are formal written complaints, a concern expressed during discussions with a health care professional, or views expressed as part of a consumer feedback survey.
3 Institute of Medicine in US preventable medical errors kill 98,000 /year100,0000 excess injure preventable medical errors : sixth leading cause of death in AmericaAggressive case finding may identify injuries and errors that are not documented in a patient's chartIf the (CDC) were to include preventable medical errors as a category, it would be theThat number translates to more than three fully loaded jumbo jets crashing every week with no survivors
5 Bureau of Justice Statistics 25% of all the doctors in USA get sued / annual50 & 65% all doctors in USA sued at least once in their career½ adverse events occurring inpatients resulted from surgery.Complications from drug treatment, therapeutic mishaps, and diagnostic errors were the most common non-operative events.
6 epidemic of medical malpractice, not of malpractice lawsuits Despite shocking number of medical errorsfew injured patients ever file a medical negligence lawsuitfewer file frivolous claimsepidemic of medical malpractice, not of malpractice lawsuits
7 Risk factors for error Healthcare Complexity Complicated technologies, powerful drugsIntensive careprolonged hospital stay adverse event increased by 6% /day in hospitalemergency departmentpart time doctors not trained in emergency care;fluctuating demand for services, which results in uneven and sometimes abbreviated care;limited time available to arrive at a definitive diagnosis;emergency department is the point of entry for acutely ill patients
8 Risk factors for errorSystem and Process DesignProblem in medical errors is not bad people in health care—it is that good people are working in bad systems that need to be made saferPoor communication/documentationDisconnected reporting systems within a hospital: fragmented systems in which numerous hand-offs of patients results in lack of coordination and errorsCost-cutting measures/staff shortage
9 Risk factors for error JCIA report : root cause >1/2 the serious adverse events in accredited hospitals was poor communicationOther leading causes :inadequate assessment of the patient's conditionpoor leadership or training
10 Risk factors for error Competency, Education, and Training Variations in healthcare provider training & experienceFailure to acknowledge the prevalence and seriousness of medical errorsJuly effect
11 Risk factors for error Human Factors Sleep deprivation Fatigue Depression and burnoutDiverse patientsAge -64patient's underlying illnessesUnfamiliar settingstime pressuresComplications increase as patient to nurse staffing ratio increases
12 Preventing medical errors will lower health care costsreduce doctors’ insurance premiumsprotect the health and well-being of patients & reduce hospital stayIn fact, the more closely we examine patient care, the more error we find. No setting is free from hazards and no specialty is immune, and patients are at risk no matter what their age, sex, or health status.
13 We are aware of no study showing that medical care can be provided without error
14 After an error has occurred, what action to take?
16 ObjectiveTo protect public health & safety by resolving investigation and prosecuting complaints about health care.
17 Types of complaint Health complaints Non health complaints Insurance CriminalFinancialBehavior
18 Medical complaint in the emirate of Dubai- accepted
19 Degree/Severity of health complaints MajorModerateMinor
20 Severity of complaints Minor complaintsComplaints that can be resolved based on the assessment findingsExample: Patients with no injury or increased length of stay
21 Severity of complaints Moderate complaintsComplaints require only assessment & might need to be investigated based on assessment findings.Example: Increased length of stay as a result of incident, Surgical intervention required as a result of an incident.
22 Severity of complaints Major complaintsComplaints that need to be investigated immediately by an investigation committee without assessment.Example: Procedure involving wrong patient or body, part, Medication error leading to death.
24 Clinical Governance Office Decision to investigateSelect investigation committee member ( private/public)Facilitate their workConclude any memberReview investigation report
25 Investigation committee Each case will consists of following committee members from the same speciality of the case:One ChairpersonAt least 2 Health Professionals registered and licensedLegal representative will be consulted upon need
26 Conflict of Interest and Confidentiality Agreement Conflict of Interest and Confidentiality AgreementتعهدWe the undersigned declare that we have no actual or potential conflict of interest; this includes both financial and other interests that could compromise our performance of our official duties or the standing of the Dubai Health Authority (DHA) Health Regulation Department.We further verify that the content of all material and information associated with our role as investigator with the DHA- Health Regulation Department will remain confidential; this includes the process of investigation and complainant / healthcare provider informationأنا الموقع أدناه اقر بعدم وجود أي مصالح شخصية أو مادية أو غيرها، مما قد يؤثر على أداء مهمة التحقيق المكلفة إلي من قبل إدارة التنظيم الصحي- هيئة الصحة بدبيكما أنني أتعهد بالتعامل مع جميع المعلومات ( إجراءات التحقيق ومعلومات المشتكي والمشتكي عليه وغيرها من المعلومات) بسرية تامة وعدم الإفصاح بأي بها لأي شخص خارج لجنة التحقيقInvestigation committee member عضو لجنة التحقيق الطبيةName:الاسمSignature:التوقيعEmployment Title:المسمى الوظيفيLicense Number:رقم الرخصةFacility Name :اسم المنشأه
27 Chairperson Decide on the meeting and send invitation Lead the meeting / Distribute the rolePrepare investigation reportSign all documentInterview is singed by doctors & complainantAvailable to discuss/clarify outTranslation
28 Chair Person/Member Sign conflict of interest and confidentiality form Review filesAttend all meetingsRespect/ introduction ( name. complaint)Conduct Interviews- venue, time, date , attendeeInvestigate medical aspectNo result to be given to complainantNot interfere with each other decisionAsk question equallyDisclosure to third party
29 Chair Person/Member Consult other specialty If compliant or healthcare professionals is not contactableMalpractice definition-lawReasons for decisionMobiles not allowedRecorder useCourtSign the report
39 Old definition Negligence Malpractice Failure to act with prudence a reasonable person with similar training & experience would exercise under same circumstances.Includes medical error in diagnosis, treatment or illness managementMalpracticeWhen negligence act or omission by a doctor or other medical professional results in damage or harm to a patient.Act or omission by a healthcare provider which deviates from accepted standards of practice & causes injury to the patient
40 New Definition Malpractice Is an error occurs due toUnfamiliarity of the practitioner with technical aspects which each practitioner assumed to be familiar withNegligencePaying insufficient efforts
41 Not MalpracticeThe following shall not be considered medical liability, if:damage was sustained due to the action of the patientphysician followed certain medical method in treatmentmedical side effect & complications know in medical practice
42 Recommendation from the medical complaint committee reviewed HRD Disciplinary action -law
43 AppealAppeal occurs when the complainant or treating doctor is not satisfied with the outcome of the complaintAppeals will be forwarded to higher authority for further actionAppeal decision not the disciplinary action
44 Criteria Appeal Appeal should fulfill the following conditions; Either Whiting 15 days of receiving the final result of the investigationNew evidenceEitherappoints appeal committee members-three members at leastReject the appeal
45 Criteria AppealDecisions shall be finalOne appeal per case
46 Writing an appeal Be professional More evidence Disciplinary action implemented after 15 daysHow effective ?Rejected / submission of the license/ assessmentAssessment panelDecision of assessment panel ( same post/ privilege/ downgrade/ under supervision)Return the license
47 Applying for reassessment SheryanAssessment iconSchedule assessment dateOn line assessment ( 10 specialties) /interviewFee
48 Contact UsBusiness village Building B third floor Office number/53