Descriptive Analysis on ICU Medical Risk Management in United Kingdom, United States, Australia, Canada and Taiwan_Chinese Journal of Evidence-Based Medicine

Authors：

SUN Niuyun ¹ , CUI Xiaohua ² ,  LIANG Minghui ¹ , WANG Li ² , LI Youping ² , CHENG Lan ² , LI Xiao ² , YUAN Qiang ²

1. National Institute of Hospital Administration, Beijing 100083, China;2. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIANG Minghui, Email: Liang2002niha@gmail.com

Keywords：

Healthcare risk; ICU; Risk management

DOI：

10.7507/1672-2531.20110062

Video：

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Objective 　To analyze the policy and guideline, the institutional management and the operation mechanism of ICU medical risk management in the United Kingdom, the United States, Australia, Canada and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China.
Methods　 Such databases as PubMed, EMBASE, The Cochrane Library were searched to include the literatures such as the guideline documents and the research reports on ICU medical risk management in the United Kingdom, the United States, Australia, Canada and Taiwan; the institutional management and the operation mechanism of the risk management in the above four countries and one area were comprehensively analyzed, and especially the UK model was highly emphasized.
Results　 A total of 31 literatures were included, including 1 guideline, 5 reviews, 2 investigative reports and 23 research documents. The United Kingdom guided the ICU risk management in forms of the standard and the guideline, formulated a clear tool of event classification and corresponding response mechanism. The United States learned from Australia’s experience and established the ICU safety reporting system; both of them regarded ICU as one part of the medical risk management and set up a special management column.
Conclusion　 The ICU risk management with the independent report system in the United Kingdom is brought into the scope of national patient safety management, and is regarded as the relative complete system at present. In Australia and the USA, the national institutions are in charge of setting up the research projects of ICU risk management; the industry associations and the non-governmental organizations lead the risk research; and the experimental units popularize gradually after self-application.

Citation： SUN Niuyun,CUI Xiaohua,LIANG Minghui,WANG Li,LI Youping,CHENG Lan,LI Xiao,YUAN Qiang. Descriptive Analysis on ICU Medical Risk Management in United Kingdom, United States, Australia, Canada and Taiwan. Chinese Journal of Evidence-Based Medicine, 2011, 11(4): 357-366. doi: 10.7507/1672-2531.20110062 Copy

1.	1 Stahl K, Palileo A, Schulman CI, et al . Enhancing Patient Safety in the Trauma/Surgical Intensive Care Unit. J Trauma , 2009, 67(3): 430-435.
2.	The Intensive Care Society. Standards for critical incident reporting in critical care (2006). [2011-1-17]Available from: URL: http://www.npsa.nhs.uk/health/resources.
3.	Reader T, Flin R, Lauche K, et al . Non-Technical Skills in the Intensive Care Unit. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
4.	Health Technology Assessment(HTA). The investigation and analysis of critical incidents and adverse events in healthcare(2005). [2011-1-17]Available from: URL: http://www.sciencedirect.com/.
5.	Spigelman AD, Swan J. Review of the Australian incident monitoring system. ANZ J of Sur , 2005, 75(8): 657-661.
6.	Wu AW, Pronovost P, Morlock L. ICU incident reporting systems. J Crit Care , 2002, 17(2): 86-94.
7.	Holzmueller CG, Pronovost PJ, Dickman F, et al . Creating the Web-based Intensive Care Unit Safety Reporting System. J Am Med Inform Assoc , 2005, 12(2): 130-139.
8.	Allan G. Improving the Intensive Care Unit. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
9.	McCauley K, Irwin RS. Changing the Work Environment in ICUs to Achieve Patient-Focused Care. Chest , 2006, 130(5): 1571-1578.
10.	Thomas AN, Pilkington CE, Greer R. Critical incident reporting in UK intensive care units: a postal survey. J Eval Clin Pract , 2003, 9(1): 59-68.
11.	Scholefield H. Safety in obstetric critical care. Best Pract Res Clin Obstet Gynaecol , 2008, 22(5): 965-982.
12.	Gunning KE. Critical incident reporting in Intensive Care. Intensive Care Med , 2000, 26(1): 8-10.
13.	Pronovost PJ, Berenholtz SM, Goeschel C, et al . Improving patient safety in intensive care units in Michigan. J Crit Care , 2008, 23(2): 207-221.
14.	Pronovost PJ, Morlock LL, Sexton JB, et al . Improving the Value of Patient Safety Reporting Systems. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
15.	Lacey S, Smith JB, Cox K. Pediatric Safety and Quality. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
16.	Suresh G, Horbar JD, Plsek P, et al . Voluntary Anonymous Reporting of Medical Errors for Neonatal Intensive Care. Pediatrics , 2004, 113(6): 1609-1618.
17.	Baldwin I, Beckman U, Shaw L, et al . Australian Incident Monitoring Study in intensive care: local unit review meetings and report management. Anaesth Intensive Care , 1998, 26(3): 294-297.
18.	Beckmann U, Baldwin I, Hart GK, et al . The Australian Incident Monitoring Study in Intensive Care: AIMS-ICU. Ananalysis of the first year of reporting. Anaesth Intensive Care , 1996, 24(3): 320-329.
19.	Beckmann U, West LF, Groombridge GJ, et al . The Australian Incident Monitoring Study in Intensive Care: AIMS-ICU. The development and evaluation of an incident reporting system in intensive care. Anaesth Intensive Care , 1996, 24(3): 314-319.
20.	Beckmann U, Bohringer C, Carless R, et al . Evaluation of two methods for quality improvement in intensive care: Facilitated incident monitoring and retrospective medical chart review. Critical Care Med , 2003, 31(4): 1006-1011.
21.	Pronovost P, Goeschel C. Improving ICU Care: It Takes a Team. Healthc Exec , 2005, 20(2): 14-22.
22.	Schuerer DJ, Nast PA, Harris CB, et al . A New Safety Event Reporting System Improves Physician Reporting in the Surgical Intensive Care Unit. J Am Coll Surg , 2006, 202(6): 881-887.
23.	Donze A, Wolf M. St. Safety in the NICU Preventing Medication Errors with Computerized Provider Order Entry. Nurs Womens Health , 2007, 11(6): 612-617.
24.	Hazlehurst B, McMullen C. Orienting frames and private routines: The role of cultural process in critical care safety. Int J Med Inform , 2007, 76(1): S129-135.
25.	Scanlon MC, Mistry KP, Jeffries HE. Determining pediatric intensive care unit quality indicators for measuring pediatric intensive care unit safety. Pediatr Crit Care Med , 2007, 8(2): S3-10.
26.	Despins LA. Patient Safety and Collaboration of the Intensive Care Unit Team. Crit Care Nurse , 2009, 29(2): 85-91.
27.	George EL, Henneman EA, Tasota FJ. Nursing implications for prevention of adverse drug events in the intensive care unit. Crit Care Med , 2010, 28(6): 136-144.
28.	Cohen MR. Healthcare Consumers: Essential Partners in Safe Medication Use(2008). [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
29.	Sinopoli DJ, Needham DM, Thompson DA, et al . Intensive care unit safety incidents for medical versus surgical patients: A prospective multicenter study. J Crit Care , 2007, 22(3): 177-183.
30.	Robin CK. Improving Medication Safety in the NICU. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
31.	Rothschild JM, Landrigan CP, Cronin JW, et al . The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med , 2005, 33(8): 1694-1700.
32.	The NPSA. Seven steps to patient safety. The full reference guide.[2010-5-12] Available from: URL: http://www.nrls.npsa.nhs.uk/resources/collections/seven-steps-to-patient-safety/.
33.	李幼平, 文进, 王莉. 药品风险管理: 概念、原则、研究方法与实践. 中国循证医学杂志, 2007, 7(12): 843-848.

1. 1 Stahl K, Palileo A, Schulman CI, et al . Enhancing Patient Safety in the Trauma/Surgical Intensive Care Unit. J Trauma , 2009, 67(3): 430-435.
2. The Intensive Care Society. Standards for critical incident reporting in critical care (2006). [2011-1-17]Available from: URL: http://www.npsa.nhs.uk/health/resources.
3. Reader T, Flin R, Lauche K, et al . Non-Technical Skills in the Intensive Care Unit. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
4. Health Technology Assessment(HTA). The investigation and analysis of critical incidents and adverse events in healthcare(2005). [2011-1-17]Available from: URL: http://www.sciencedirect.com/.
5. Spigelman AD, Swan J. Review of the Australian incident monitoring system. ANZ J of Sur , 2005, 75(8): 657-661.
6. Wu AW, Pronovost P, Morlock L. ICU incident reporting systems. J Crit Care , 2002, 17(2): 86-94.
7. Holzmueller CG, Pronovost PJ, Dickman F, et al . Creating the Web-based Intensive Care Unit Safety Reporting System. J Am Med Inform Assoc , 2005, 12(2): 130-139.
8. Allan G. Improving the Intensive Care Unit. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
9. McCauley K, Irwin RS. Changing the Work Environment in ICUs to Achieve Patient-Focused Care. Chest , 2006, 130(5): 1571-1578.
10. Thomas AN, Pilkington CE, Greer R. Critical incident reporting in UK intensive care units: a postal survey. J Eval Clin Pract , 2003, 9(1): 59-68.
11. Scholefield H. Safety in obstetric critical care. Best Pract Res Clin Obstet Gynaecol , 2008, 22(5): 965-982.
12. Gunning KE. Critical incident reporting in Intensive Care. Intensive Care Med , 2000, 26(1): 8-10.
13. Pronovost PJ, Berenholtz SM, Goeschel C, et al . Improving patient safety in intensive care units in Michigan. J Crit Care , 2008, 23(2): 207-221.
14. Pronovost PJ, Morlock LL, Sexton JB, et al . Improving the Value of Patient Safety Reporting Systems. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
15. Lacey S, Smith JB, Cox K. Pediatric Safety and Quality. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
16. Suresh G, Horbar JD, Plsek P, et al . Voluntary Anonymous Reporting of Medical Errors for Neonatal Intensive Care. Pediatrics , 2004, 113(6): 1609-1618.
17. Baldwin I, Beckman U, Shaw L, et al . Australian Incident Monitoring Study in intensive care: local unit review meetings and report management. Anaesth Intensive Care , 1998, 26(3): 294-297.
18. Beckmann U, Baldwin I, Hart GK, et al . The Australian Incident Monitoring Study in Intensive Care: AIMS-ICU. Ananalysis of the first year of reporting. Anaesth Intensive Care , 1996, 24(3): 320-329.
19. Beckmann U, West LF, Groombridge GJ, et al . The Australian Incident Monitoring Study in Intensive Care: AIMS-ICU. The development and evaluation of an incident reporting system in intensive care. Anaesth Intensive Care , 1996, 24(3): 314-319.
20. Beckmann U, Bohringer C, Carless R, et al . Evaluation of two methods for quality improvement in intensive care: Facilitated incident monitoring and retrospective medical chart review. Critical Care Med , 2003, 31(4): 1006-1011.
21. Pronovost P, Goeschel C. Improving ICU Care: It Takes a Team. Healthc Exec , 2005, 20(2): 14-22.
22. Schuerer DJ, Nast PA, Harris CB, et al . A New Safety Event Reporting System Improves Physician Reporting in the Surgical Intensive Care Unit. J Am Coll Surg , 2006, 202(6): 881-887.
23. Donze A, Wolf M. St. Safety in the NICU Preventing Medication Errors with Computerized Provider Order Entry. Nurs Womens Health , 2007, 11(6): 612-617.
24. Hazlehurst B, McMullen C. Orienting frames and private routines: The role of cultural process in critical care safety. Int J Med Inform , 2007, 76(1): S129-135.
25. Scanlon MC, Mistry KP, Jeffries HE. Determining pediatric intensive care unit quality indicators for measuring pediatric intensive care unit safety. Pediatr Crit Care Med , 2007, 8(2): S3-10.
26. Despins LA. Patient Safety and Collaboration of the Intensive Care Unit Team. Crit Care Nurse , 2009, 29(2): 85-91.
27. George EL, Henneman EA, Tasota FJ. Nursing implications for prevention of adverse drug events in the intensive care unit. Crit Care Med , 2010, 28(6): 136-144.
28. Cohen MR. Healthcare Consumers: Essential Partners in Safe Medication Use(2008). [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
29. Sinopoli DJ, Needham DM, Thompson DA, et al . Intensive care unit safety incidents for medical versus surgical patients: A prospective multicenter study. J Crit Care , 2007, 22(3): 177-183.
30. Robin CK. Improving Medication Safety in the NICU. [2011-1-17] Available from: URL: http://www.sciencedirect.com/.
31. Rothschild JM, Landrigan CP, Cronin JW, et al . The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med , 2005, 33(8): 1694-1700.
32. The NPSA. Seven steps to patient safety. The full reference guide.[2010-5-12] Available from: URL: http://www.nrls.npsa.nhs.uk/resources/collections/seven-steps-to-patient-safety/.
33. 李幼平, 文进, 王莉. 药品风险管理: 概念、原则、研究方法与实践. 中国循证医学杂志, 2007, 7(12): 843-848.

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