Safety management in routine medical practice is one of the important issues that must be addressed by medical staffs, even it is hard to deal with various happenings and problems encountered in medical facilities.Here we present some arrangements in a reporting system of incidents and accidents to motivate each staffer to notice the significance of safely, and quantify the urgency and severity of reports using the originally developed management score at the Toride Kyodo General Hospital.The reports from all sections of the hospital were previously evaluated by five risk managers. This practice was effective in analyzing reports rapidly and appropriately, but was insufficient to motivate all of staffs to give much more heed to safety in routine medical practice. Instead, these reports are now discussed and analyzed by a group of people consiting of representatives of all sections and the departments in the hospital. This innovation evoked more interest and concerns about the safety management among the whole medical staff.We also utilized the management level, which was stratified into three grades from the point of urgency and severity of cases. The first level means the occurrence without urgency or need to change any systems, procedures and organizations. The second level requires some change in systems, but no urgent action. The accident at the third level should be dealt with as soon as possible by any of feasible ways. The total score, obtained by summing up a lisk level multiplied by a management level in each report, decreased between May and August in 2004, despite increases in the total numbers of monthly reports.In conclusion, the incident/accident reporting system became more familiar to medical staffs through the use of group-working. The management score and the derived total score may be available for comparing outcomes of safety management activities among different observation periods or facilities.
Reporting ; Safety ; Accidents ; Analysis ; Management

Background and Purpose: Every patient experiences a nervous period of waiting before a surgical operation. We make a point of visiting patients for friendly chats with them before the day of Jurgery to reduce their anxieties. This study was conducted to evaluate the results of the preoperative visits to mentally support the patients and rapidly obtain their confidences by a method of “transactional analysis.”
Methods: Fourteen nurses of the operating section in our hospital visited 120 patients prior to surgical operations requiring general anesthesia between March and May in 1994, and recorded the communications for “transactional analysis.”
Results: The communications were completely documented in 21 out of 120 patients. The preoperative visit and communications reduced the anxieties in 18 out of the 21 patients (86%).
Conclusions: The preoperative visit and cummunications were useful for establishing confidences between nurses and approximately 90 percentage of the patients.