환자의 안전과 환자안전법제에 관한 고찰

Abstract

Technical advances bring more benefits for people in the health care. Splendid knowledge, more honed skills and technical advances bring sophisticated treatments to lager populations of people than ever before. On the other hand, they bring benefits by learning how other high risk enterprises, such as aviation, nuclear power generation, have confronted considerable technical challenges in the pursuit of safe operations and public confidence. But health care is a decade or more behind other high-risk industries in its attention to ensuring basic safety. Aviation and nuclear power generation have focused on building safe systems, because harm occurs to whole groups of passengers or residents. In health care, the damage happens to a third party; the patient is harmed; the health professional or the organization, only rarely. Furthermore, harm occurs to only one patient at a time; not whole groups of patients, making the accident less visible. Systems can be very large and far-reaching, or they can be more localized. In health care, a system can be an integrated delivery system, a centrally owned multi-hospital system, or a virtual system comprised of many different partners over a wide geographic area. However, an operating room or an obstetrical unit is also a type of system. Furthermore, any element in a system probably belongs to multiple systems. The variable size, scope, and membership of systems make them difficult to analyze and understand. The decentralized and fragmented nature of the health care delivery system also contributes to unsafe conditions for patients, and serves as an impediment to efforts to improve safety. Even within hospitals and large medical groups, there are rigidly-defined areas of specialization and influence. For example, when patients see multiple providers in different settings, none of whom have access to complete information, it is easier for something to go wrong than when care is better coordinated. At the same time, the provision of care to patients by a collection of loosely affiliated organizations and providers makes it difficult to implement improved clinical information systems capable of providing timely access to complete patient information. Unsafe care is one of the prices we pay for not having organized systems of care with clear lines of accountability. So we need to ensure safe care. That is why Korea enacts law of patient safety in 2015. But the law focused on the report system of informations about medical accidents. It is not enough to prevent patient's injuries. So, it needs to make up the weak points in the law.