QUALITY OF THE MEDICAL SERVICES IN THE OBSTETRICS AND GYNAECOLOGY PRACTICE IN BULGARIA - DATA FROM INSPECTIONS PERFORMED BY MEDICAL AUDIT EXECUTIVE AGENCY
Journal Title: Българско списание за обществено здраве (Bulgarian Journal of Public Health) - Year 2018, Vol 0, Issue 4
Abstract
This study researches and analyzes the public information regarding inspections made by Executive Agency “Medical Audit” /EAMA/ of medical institutions in the country - specialized obstetrics and gynaecology hospitals and wards in multidisciplinary hospitals, related to Obstetrics and Gynaecology activities (OG), oncogynaecology, neonatology and reproductive medicine for a period of three years (2014 - 2016) with the purpose to determine the main reasons requiring the inspections, the presence, frequency and reasons for an unpleasant event occuring based on the expert assessment of EAMA. Materials and methods: 210 orders for performing an inspection, 264 inspections, 125 medical institutions are inspected. Results: More than half of the patient complaints received in EAMA and respectively the violations established are associated with the obstetric care. The percentage of the medical errors made in the gynaecological practice is statistically significantly smaller in case of treatment or surgical intervention conducted with a “choice of team”, unlike the obstetrics practice where statistically significant difference is not established. In over one third of the inspections made by EAMA, a medical error is present, leading to a mild, severe damage or death. The presence of a medical error in the obstetrics and gynaecology practice is a result mostly of: 1) insufficient adequacy of the actions taken by the medical staff; 2) insufficient volume of medical actions; 3) timeliness of performing a necessary manipulation and 4) impaired communication and coordination of the actions during the diagnostic-therapeutic process. Conclusion: The study outlines the necessity of future actions in direction of: building a system for reporting medical errors made; management of the risk as a process of identifying, assessment, analysis and management of all the potential risks, prevention from the omissions and failures in the obstetrics and gynaecology practice.
Authors and Affiliations
Zlatitsa Petrova, Ivan Kostov, Elisaveta Petrova-Jeretto
Keywords
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