Emergency management of doctor–patient group incidents in a regional general hospital based on the 4R crisis management theory

Growing clinical complexity and healthcare demand can intensify medical disputes, and patient deaths or severe complications may be followed by collective disruptive events. This single-center retrospective descriptive case series used the 4R crisis management framework (Reduction, Readiness, Response, and Recovery) to organize the review of 10 doctor–patient group incidents documented in a regional general hospital from 2013 to 2023. We summarized incident characteristics, departments, collective behaviors, handling pathways, record-coded contributing factors, and documented hospital activities, and mapped each incident to the four 4R stages using predefined coding rules. All included incidents followed a patient death. Four incidents occurred in pediatrics or neonatology, and two occurred in cardiothoracic surgery. Frequently documented collective behaviors included ward or body retention (9/10), banners or memorial displays (7/10), obstruction of clinicians or offices (5/10), and online dissemination (2/10). The 4R mapping provided a stage-based description of recorded risk communication, preparedness, on-site response, and post-incident follow-up activities. It also supported the development of a proposed organizational framework for future process review. Because the study had no comparison group or standardized response and recovery outcomes, the findings do not establish the effectiveness or causal effects of any management measure.