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Incident investigations by the regulatory authority of Swedish healthcare - a 20-year perspective

Wrigstad, Jonas LU ; Bergström, Johan LU and Gustafson, Pelle LU (2015) In Journal of Hospital Administration 4(6). p.68-76
Abstract
Objective: The purpose of this study was to describe procedural changes in hospital incident investigations and show the consequences of these changes over time.



Methods: A two-stage method was used. First component of the study was a content analysis of 87 incident investigations conducted 1995-2014 by the regulatory authority after adverse events in a Swedish university hospital. Second component was conducting semi-structured interviews with 11 investigators from all regulatory authority regional offices in Sweden.



Results: In a minority of incident investigations, where further demands for action were required by the regulatory authority, a major portion of these were aimed at the micro-level. A... (More)
Objective: The purpose of this study was to describe procedural changes in hospital incident investigations and show the consequences of these changes over time.



Methods: A two-stage method was used. First component of the study was a content analysis of 87 incident investigations conducted 1995-2014 by the regulatory authority after adverse events in a Swedish university hospital. Second component was conducting semi-structured interviews with 11 investigators from all regulatory authority regional offices in Sweden.



Results: In a minority of incident investigations, where further demands for action were required by the regulatory authority, a major portion of these were aimed at the micro-level. A plan for follow-up was expressed in only one tenth of the investigations. All investigators had a background from the healthcare system and saw this as advantageous. Their personal memory was claimed to be the only tool when referring to previous cases. Less fieldwork, more office work and more uniformity of language were recognised changes in comparison over time. The role of doing “auditing” was the most common description by the investigators themselves.



Conclusions: The micro-level focus of the investigations reflected an organisational structure within the regulatory authority. We saw signs of parallel system weaknesses within the Swedish healthcare system with a clear absence of formalised organisational memory and a malfunctioning follow-up system of incident investigations. This can be seen both regarding the healthcare providers and the regulatory authority. The reports from the qualitative interviews data indicated that “auditing at the office” was considered the main occupation in incident investigations conducted by the regulatory authority. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Incident investigation, Regulatory authority, Organisational change, Role, Surveillance, Organisational memory, Follow-up
in
Journal of Hospital Administration
volume
4
issue
6
pages
68 - 76
publisher
Sciedu Press
ISSN
1927-6990
DOI
10.5430/jha.v4n6p68
language
English
LU publication?
yes
id
2db0e001-5287-4fd7-97e8-87e931796e68 (old id 7860230)
date added to LUP
2015-09-29 14:05:53
date last changed
2016-04-16 02:26:51
@article{2db0e001-5287-4fd7-97e8-87e931796e68,
  abstract     = {Objective: The purpose of this study was to describe procedural changes in hospital incident investigations and show the consequences of these changes over time.<br/><br>
<br/><br>
Methods: A two-stage method was used. First component of the study was a content analysis of 87 incident investigations conducted 1995-2014 by the regulatory authority after adverse events in a Swedish university hospital. Second component was conducting semi-structured interviews with 11 investigators from all regulatory authority regional offices in Sweden.<br/><br>
<br/><br>
Results: In a minority of incident investigations, where further demands for action were required by the regulatory authority, a major portion of these were aimed at the micro-level. A plan for follow-up was expressed in only one tenth of the investigations. All investigators had a background from the healthcare system and saw this as advantageous. Their personal memory was claimed to be the only tool when referring to previous cases. Less fieldwork, more office work and more uniformity of language were recognised changes in comparison over time. The role of doing “auditing” was the most common description by the investigators themselves.<br/><br>
<br/><br>
Conclusions: The micro-level focus of the investigations reflected an organisational structure within the regulatory authority. We saw signs of parallel system weaknesses within the Swedish healthcare system with a clear absence of formalised organisational memory and a malfunctioning follow-up system of incident investigations. This can be seen both regarding the healthcare providers and the regulatory authority. The reports from the qualitative interviews data indicated that “auditing at the office” was considered the main occupation in incident investigations conducted by the regulatory authority.},
  author       = {Wrigstad, Jonas and Bergström, Johan and Gustafson, Pelle},
  issn         = {1927-6990},
  keyword      = {Incident investigation,Regulatory authority,Organisational change,Role,Surveillance,Organisational memory,Follow-up},
  language     = {eng},
  number       = {6},
  pages        = {68--76},
  publisher    = {Sciedu Press},
  series       = {Journal of Hospital Administration},
  title        = {Incident investigations by the regulatory authority of Swedish healthcare - a 20-year perspective},
  url          = {http://dx.doi.org/10.5430/jha.v4n6p68},
  volume       = {4},
  year         = {2015},
}