ABSTRACT
Objective:
To analyze the
risk factors of medical
damage liability in the
ambulance management in
China, and provide reference for strengthening such management and improving the pre-
hospital emergency system.
Methods:
The
judgment documents released by
China Judgment Online from 2013 to 2022 regarding damages incurred by improper
ambulance management, were used as the sample. Based on the setting of such
elements as
software, hardware,
environment, and liveware in the SHEL model, the text
analysis method was applied to encode the text content at three levels according to " main category-sub category-
risk behavior" by means of NVivo 12.0
software.
Results:
A total of 136 valid sample
documents were included, finalizing such four main categories as
software, hardware,
environment, and liveware. Also finalized were 11 subcategories and 30
risk behaviors. The subcategories included the professional
awareness and
ability of pre-
hospital emergency managers, the professional
awareness of
medical staff, the professional quality and
ability of
medical staff, as well as vehicle
equipment among others. A total of 187 reference points were identified for
coding risk behaviors.
Risk behaviors with higher reference points included failure of pre-
hospital emergency managers to dispatch vehicles (45), incomplete, malfunctioning, or no backup
equipment in vehicles (20), failure of
medical staff to take
treatment measures in vehicles (18), failure to dispatch accompanying
medical staff or
stretchers (14), and insufficient medication (14), and fall of
patients or medical
equipment incurred by sudden braking of the
drivers (6) among others.
Conclusions:
Insufficient
ambulance equipment, shortage of
human resources in the
emergency system, inadequate
equipment and medication in
emergency vehicles, and
safety issues for
drivers are
risk factors in the management of
ambulances in
China. It is recommended to expand the
first aid talent team and enhance
first aid capabilities; Reasonably deploy
ambulance vehicles and improve the
emergency networks; Develop a list of
pharmaceutical equipment and establish an
early warning mechanism; Strengthen the multi-party coordination, improve the
efficiency of
referral, further reduce the
probability of
risk, ensure the quality of
emergency treatment, and enhance the
effectiveness of pre-
hospital emergency treatment.
