• 보건행정학회지
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• 제25권3호
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• pp.174-184
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• 2015

This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.

• 의료법학
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• 제19권1호
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• pp.81-111
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• 2018

최근 우리나라에서는 연속적으로 발생한 환자안전사건으로 인해 환자안전에 대한 사회적 관심이 높아졌다. 더불어 환자안전사건 발생 후 의료인 및 의료기관의 대응방식이 논란이 되면서, 사과법 및 디스클로져법 도입의 필요성이 제기되고 있다. 본 연구에서는 미국의 사과법과 디스클로져법 내용을 분석하고, 우리나라의 입법 움직임에 대하여 비판적으로 검토하고자 한다. 먼저 사과법은 의료인 등이 환자측에게 불편감, 통증, 손상, 사망 등에 대해 사과나 위로, 공감 등을 표하는 경우, 사과 등의 표현은 민사재판 및 행정절차에서 법적인 증거로 사용할 수 없도록 하는 것을 그 주요 내용으로 한다. 사과법은 실수, 오류, 잘못, 책임, 법적 책임의 표현과 같은 규범적 평가요소를 증거법의 보호 범위에 포함하는지 여부에 따라 '완전한 사과법'과 '부분적 사과법'으로 구분된다. 한편, 디스클로져법은 의료기관이 심각한 위해가 발생한 사건 등에 있어 사건의 공개, 발생원인, 보상계획, 재발방지대책 등에 관하여 환자 측과 소통하는 것을 법률상 강제하거나 자율적으로 유도하는 것을 그 주요 내용으로 한다. 한편, 최근 우리나라에서도 환자안전사고에 관한 관심이 증폭되고, 의료인 측과 환자측의 의사소통의 중요성이 인식되면서, 위와 같은 미국의 사과법 또는 디스클로져법을 수용한 "환자안전법" 개정법률안이 국회에 제출되기도 하였다. 본 연구에서는 미국의 사과법 및 디스클로져법의 분석을 토대로 위 개정법률안의 내용을 비판적으로 검토함으로써 향후의 입법방향에 시사점을 제시하고자 한다.

• KIEAE Journal
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• 제17권1호
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• pp.55-61
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• 2017

Purpose : As the necessity of reinforcement of infections management in medical facilities after MERS increased, Ministry of Health and Welfare promulgated the enforcement regulations of medical law on February 3, 2017. Its main objective is to improve patients' safety and medical-care quality through the establishment of isolation facilities from infectious diseases and the set-up of standards for In-patient and ICU facilities. The purpose of this study is necessarily to propose a standardized spatial composition model for ward modules by analyzing changing environments of in-patient facilities according to the strengthened medical law. Method: Theoretical studies will be undergone of Evidence-based Designs to improve patients' safety, medical quality, and domestic/overseas in-patient room guidelines. With reference to the status of 24 general hospitals over 500 beds, the spatial compositions of the in-patient rooms and the types of multi/single bed room modules will be analyzed. The directions of future in-patient room module changes through the study of the minimum ward module types and various ward types will be presented. Result: This paper will hopefully provide guidelines for hospitalization rooms that can be applied to the revised rules of medical law enforcement and provide a basis for a comprehensive study of patients' safety and efficient infection control as well.

• 문화기술의 융합
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• 제4권2호
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• pp.33-42
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• 2018

2015년 1월 28일 제정되었던 환자안전법이 2016년 7월 26부터 시행되고 있다. 환자안전법은 환자안전문제에 있어 사후적인 민 형사상 책임추궁에 초점을 두고 있던 과거시스템에서 탈피하여 사전적으로 의료오류(medical error)의 예방을 위해 보고시스템을 통하여 각종 오류를 수집 집적한 후 얻어진 결과물을 진료에 반영함으로써 위해를 예방하고자 하는 방식으로 이루어져 있다. 이 법의 유효성을 위해서는 환자안전사고의 예방 보고 재발 방지 등을 위한 환자안전관리체계구축의 핵심적인 전제인 '환자안전사고의 자율보고 및 보고 학습시스템'의 활성화가 관건이다. 그리고 이 시스템이 활성화되기 위해서는 무엇보다도 많은 양의 보고자료축적이 필수적인 전제요건이다. 그럼에도 불구하고 약 17개월 동안 단 2건에 불과한 보고가 있었을 뿐이다. 외국의 선례에서는 이 문제를 해소하기 위하여 부분적으로 의무보고시스템을 도입하고 있다. 본 글에서는 현행 자율보고시스템의 타당성과 발의되어 있는 두 개정안을 비판해보고, 부분적 의무보고시스템의 도입을 제시해보고자 한다.

• 의학교육논단
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• 제21권3호
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• pp.143-149
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• 2019

In 2018, The Ministry of Health and Welfare announced its first comprehensive plan for patient safety, which included the imperative to develop a patient safety curriculum for students studying to become health professionals. The aim of this study is to assess current patient safety education and points of consideration for introducing new curriculum. An online survey was used to understand the status of patient safety education in medical schools, and key informant interviews and focus group interviews were used to collect qualitative data on the experience of patient safety education. The results of the online survey from 16 out of 40 medical schools (40% response rate) and the qualitative data analysis were integrated and analyzed. Twelve schools (75%) had established courses related to patient safety. The qualitative responses suggest that patient safety education is appropriate both before and after clinical training through a variety of educational methods, and that the topics should be linked with clinical training. The challenge of securing lecture time to address patient safety was mentioned as a realistic obstacle. When patient safety education is integrated in future curriculum, it is necessary to consider it as a priority. Moreover, in the early stages of introducing patient safety education, a step-by-step, policy-based approach is required for seamless adoption and settlement.

• 한국중재학회지:중재연구
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• 제32권4호
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• pp.3-31
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• 2022

In the past, there has not been a law with the main purpose of preventing or preventing a risk in advance in order to protect the safety of patients in relation to medical services. It is evaluated that the enactment of the Patient Safety Act has a very important meaning in protecting patient safety as the top priority and further improving the quality of medical care. However, looking at the status of patient safety accidents reported to the Patient Safety Reporting System after the Patient Safety Act was enacted and implemented, various types of risk factors for patient safety still exist in the medical field. Meanwhile, Korea Consumer Agency and Korea Medical Dispute Mediation and Arbitration Agency, the existing domestic ADR specialized agencies, have been operating reasonable damage relief procedures such as recommendation of settlement, mediation, and arbitration according to the purpose of their establishment. Therefore, with the aimof broadening the choice of compensation system for patients, we propose the establishment and revision of ADR-related laws to apply the damage relief procedures of both institutions.

• 한국의료질향상학회지
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• 제23권2호
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• pp.37-54
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• 2017

Objectives: The purpose of this preliminary study was to identify the nurses' perception regarding disclosure of patient safety incidents (DPSI) and to evaluate the effectiveness of education for DPSI. Methods: DPSI education was conducted for nurses majoring in clinical nurse specialist at an university. Before and after the education, the nurses made a questionnaire to evaluate the perception of DPSI. The questionnaires were divided into four categories: first, overall perception of the DPSI; second, recognition evaluation of the DPSI using hypothetical case, third, opinion on legal and nonlegal measures for facilitating the DPSI; and fourth, socio-demographic factors. The Wilcoxon signed rank test was performed on the DPSI questionnaire response to compare the perceptions before and after the education. Results: A total of 10 nurses participated in the education. DPSI education showed the possibility of improving the overall perception, necessity, effect, obstacle, and promotion method of DPSI, although there were also several responses where there was no statistical significance. In particular, DPSI education led to statistically significance change in the perception of obstacles for DPSI. For example, the number of respondents who agreed to the item "DPSI will increase the incidence of medical lawsuits." was 7 before education but decreased to 3 after education (P-value: .025) Furthermore, nurses' perception of DPSI from this study was generally positive regardless of education. Conclusion:In the future, it will be necessary to carry out DPSI education and training and to evaluate its effectiveness for more nurses.

• 한국콘텐츠학회논문지
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• 제13권6호
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• pp.380-389
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• 2013

급성기 병원의 간호사 배치수준은 환자안전 및 성과에 영향을 미치며, 간호사 배치기준의 법제화는 환자안전에 필요한 최소 인원을 보장하는 중요한 수단이 될 수 있다. 우리나라는 의료법에 간호사 정원기준을 제시하고 있으나, 환자안전 보장 및 간호의 질 향상을 위해서 다음의 몇 가지 사항에 대한 개선이 필요하다. 첫째 1962년 제정된 현행 의료법의 간호사 정원기준은 보건의료환경 변화에 따라 적정성에 대한 재검토가 필요하다. 둘째 의료법의 간호사 정원은 의료기관이 준수하여야할 최소 인원으로 모든 의료기관이 준수하도록 관리되어야 한다. 셋째, 간호사 배치기준은 환자의 이해를 돕고, 관리가 용이하도록 근무조당 입원환자수 대 간호사 수를 기준으로 하도록 한다. 넷째, 병원 간호단위별 근무조별 간호인력 배치정보를 공개하여야 한다.

• 한국의료질향상학회지
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• 제26권2호
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• pp.104-112
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• 2020

This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.

• 의료법학
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• 제15권2호
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• pp.123-163
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• 2014

As results of analyzing judicial precedents about infection in hospitals in connection with mistakes and causality in medical litigations shows that the Mitigation of Law Principles To Prove responsibility in medical litigation has not been able to play its role compared to its intended purposes. And Major sentiment from those judgments is that a mistake can't be proved only by the fact that certain infection in hospital occurred in connection with hospital infection. Therefore, the number of indirect facts to deny estimation is overwhelmingly high. Like this, especially for hospital infection which is difficult to prove indirect facts themselves to estimate mistake, major sentiment from those judgments have a problem that impute sharing of losses caused by hospital infection to patient. In accordance with the Principles of equitable and proper sharing of losses, it's required to prepare legal interpretation and theoretical methods to largely mitigate patient's responsibility to prove medical mistakes compared to other medical litigations in connection with existing Mitigation of Law Principles To Prove responsibility and conventional theory of estimation. In connection with this, the results of review that duty of safety management in hospital infection cases can be the base of conversion of proving responsibility, the duty that prevent hospital infection, corresponding the duty of safety management in hospital infection is not conventional duty of safety management based on duty of good faith but secondary obligation of medical contract. The breach of duty preventing hospital infection is the violation of medical contract, but there is no logical necessity that convert proving responsibility from the obligation of contract itself. Therefore, the duty of preventing hospital infection from the obligation of medical contract, corresponding the duty of safety management in hospital infection cases cannot be the base of conversion of proving responsibility alone. But, it's still required to conversion of proving responsibility in hospital infection, we need further studies on cases of Germany which applies legal estimation of proving responsibilities in hospital infection.