基于FOCUS-PDCA构建医疗安全(不良)事件上报体系
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摘要
目的利用FOCUS-PDCA构建员工主动报告的不良事件上报体系,为持续提升医院质量与安全提供依据。方法根据FOCUS-PDCA,找出医院不良事件上报数低的根本原因,并针对改进,采用Kruskal-Wallis H检验进行统计分析,比较D阶段前后上报情况的差异,安全文化意识的变化,同时标准化有效措施。结果 D阶段较D阶段前,不良事件季度上报数增长2. 2倍,上报情况差异有统计学意义(H=10. 9,P <0. 05);员工对不良事件管理的认可率及支持率明显提升,排斥率明显降低。结论通过"评价办牵头、多部门联动"的管理模式,优化流程、宣传培训、经济奖励、及时处理,医院构建了较为完善的医疗安全(不良)事件上报体系,助力安全生产。
Objective To provide some basis for continuous improvement of hospital quality and safety,we use FOCUS-PDCA to establish medical safety( adverse) event reporting system. Methods By using FOCUS-PDCA,the root cause of low report numbers of hospital adverse events was found,and targeted measures was implemented. By using Kruskal-Wallis H test,we compared the differences of reporting situation and safety culture consciousness before and after the"Do stage",and standardized effective measures. Results Quarterly report numbers of adverse events in the "Do stage"increased 2. 2 times compared to the"pre-DO stage",and the difference was statistically significant( H = 10. 9,P < 0. 05).The approval rate and support rate of employees for the management of adverse events were significantly increased,while the rejection rate was significantly reduced. Conclusion Through the management mode " led by the evaluation office and coordinated by multiple departments",the hospital has established a relatively well-developed medical safety( adverse) event reporting system to facilitate the safe production by optimizing process,publicity and training,financially rewarding and timely processing.
Objective To provide some basis for continuous improvement of hospital quality and safety,we use FOCUS-PDCA to establish medical safety( adverse) event reporting system. Methods By using FOCUS-PDCA,the root cause of low report numbers of hospital adverse events was found,and targeted measures was implemented. By using Kruskal-Wallis H test,we compared the differences of reporting situation and safety culture consciousness before and after the"Do stage",and standardized effective measures. Results Quarterly report numbers of adverse events in the "Do stage"increased 2. 2 times compared to the"pre-DO stage",and the difference was statistically significant( H = 10. 9,P < 0. 05).The approval rate and support rate of employees for the management of adverse events were significantly increased,while the rejection rate was significantly reduced. Conclusion Through the management mode " led by the evaluation office and coordinated by multiple departments",the hospital has established a relatively well-developed medical safety( adverse) event reporting system to facilitate the safe production by optimizing process,publicity and training,financially rewarding and timely processing.
引文
[1]张宗久.中国医院评审实务[M]. 1版.北京:人民军医出版社,2013.
[2] THOMAS E J,STUDDERT D M,BURSTIN H R,et al. Incidence and types of adverse events and negligent care in Utah and Colorado[J]. Med Care,2000,38(3):261-271.
[3] BAKER G R,NORTON P G,FLINTOFT V,et al. The Canadian Adverse Events Study:the incidence of adverse events among hospital patients in Canada[J]. CMAJ,2004,170(11):1678-1686.
[4]程艳,颜建华,刘岩,等.医疗不良事件报告系统利用现状调查[J].中国医院管理,2014(10):41-43.
[5] INTERNATIONAL J C. Joint Commission International Accreditation Standards for Hospitals(6th Edition)[M]. U. S. A:2017.
[6]国家卫生计生委法制司.医疗质量管理办法[Z]. 2016.
[7]高红梅,谌静,钟平,等.湖南省护理人员对护理不良事件报告认知及影响因素研究[J].中国现代医学杂志,2014(23):101-106.
[8]梁小敏,陈亭儒,周惠联.跌倒不良事件现状与影响因素分析[J].现代医院,2017,17(7):950-952.
[9]医疗不良事件定义及分类[J].中国卫生质量管理,2014(4):28.
[10]陆彩云,胡少华.外科护士不良事件报告认知、态度及行为意向调查分析[J].临床护理杂志,2015(2):64-66.
[11]胡少华,李伦兰,张庆娜,等.三级甲等医院护士对不良事件报告认知与态度的影响因素分析[J].护理实践与研究,2015(9):75-78.
[2] THOMAS E J,STUDDERT D M,BURSTIN H R,et al. Incidence and types of adverse events and negligent care in Utah and Colorado[J]. Med Care,2000,38(3):261-271.
[3] BAKER G R,NORTON P G,FLINTOFT V,et al. The Canadian Adverse Events Study:the incidence of adverse events among hospital patients in Canada[J]. CMAJ,2004,170(11):1678-1686.
[4]程艳,颜建华,刘岩,等.医疗不良事件报告系统利用现状调查[J].中国医院管理,2014(10):41-43.
[5] INTERNATIONAL J C. Joint Commission International Accreditation Standards for Hospitals(6th Edition)[M]. U. S. A:2017.
[6]国家卫生计生委法制司.医疗质量管理办法[Z]. 2016.
[7]高红梅,谌静,钟平,等.湖南省护理人员对护理不良事件报告认知及影响因素研究[J].中国现代医学杂志,2014(23):101-106.
[8]梁小敏,陈亭儒,周惠联.跌倒不良事件现状与影响因素分析[J].现代医院,2017,17(7):950-952.
[9]医疗不良事件定义及分类[J].中国卫生质量管理,2014(4):28.
[10]陆彩云,胡少华.外科护士不良事件报告认知、态度及行为意向调查分析[J].临床护理杂志,2015(2):64-66.
[11]胡少华,李伦兰,张庆娜,等.三级甲等医院护士对不良事件报告认知与态度的影响因素分析[J].护理实践与研究,2015(9):75-78.
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