目的:過去十多年以來,臺灣以鼓勵自願性通報(Taiwan Patient-safety Reporting system, TPR)作為提升病安文化的方式,在「醫療事故預防及爭議處理法」實施後,未來凡符合「重大醫療事故」定義者皆需進行法定通報,本文整理比較各國通報制度,作為臺灣實施之參考。結果:比較臺灣與各國之異同:臺灣病安通報發展模式與英國相近,先由自願性通報開始,發展至法定通報;澳洲由各地方政府自訂法定通報事項,其中Safer Care Victoria(SCV)的11類Sentinel Event(SE)法定通報事件,可作為定義重大醫療事故(Never Events)時的參考,此外,澳洲由獨立單位負責根本原因分析調查,可作為臺灣推動之參考。結論:醫預法施行後仍需持續監測評估此一法定通報制度之成效,以達到預防及促進病人安全之目的。
Purpose: To improve patient safety in the event of medical accidents or malpractice, Tawan adopted a voluntary system for patients to report complaints, as mandated by the Medical Accident Prevention and Disputes Resolution Act (hereafter, the Act). The Act defines unacceptable outcomes as "Never Events" that are subject to mandatory reporting. This comparative study analyzed the healthcare outcomes of different reporting systems used in Taiwan and abroad. Result: Taiwan's development of its patient safety reporting system is similar to that in the United Kingdom which was marked by a transition from voluntary to mandatory reporting. In Australia, local governments define their own standards for mandatory reporting, among which the 11 types of mandatory reporting for Sentinel Events of Safer Care Victoria can serve as a reference for Taiwan's definition of Never Events. Moreover, Australia has an independent body that is responsible for root cause analysis. Taiwanese authorities can consider establishing a similar body to promote root cause analysis following the implementation of the Act. Conclusion: The mandatory reporting system stipulated by the Act must be continually evaluated to achieve prevention and promotion of the culture of patient safety in Taiwan.