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find Keyword "医疗安全" 15 results
  • Establishment of hospital standardization venous thromboembolism prevention and management system

    Venous thromboembolism (VTE) is a high-risk complication in hospitalized patients, especially in patients with orthopedic surgery, neurosurgery, thoracic surgery, cardiac surgery and tumor surgery. It is also a significant cause of patients’ unexpected death and perioperative death. Through establishment of norms of VTE management system and organizational structure, formulation of perfect VTE risk assessment system and prevention and treatment scheme for hospitalized patients, training of all the medical staff for related knowledge, and test operation of the system in key departments, we established a hospital standardized system of venous thromboembolism prevention and management. Our VTE prevention and treatment work achieved good results through multidisciplinary collaboration.

    Release date:2017-02-22 03:47 Export PDF Favorites Scan
  • Evaluation of Safety and Quality of 5 520 Cases in Day Surgery

    ObjectiveTo evaluate the safety and quality of patients in day surgery. MethodsThe clinical data of patients in day surgery from March to December 2014 in this hospital were collected. The incidence of complications, delayed discharge rate, rate of readmission to hospital, satisfaction, and so on, were analyzed. ResultsOf 5 520 patients were in day surgery, including laporoscopic cholecystectomy, hernia repair surgery, vocal cord polyps resection, breast minimally invasive surgery, varicose vein of lower limb, choledochoscopy, gastrointestinal polyposis, and so on. No patient was loss of follow-up, unplanned reoperation or death after day surgery. There were 39.95%(2 205/5 520) of wound pain and 0.51%(28/5 520) of postoperative nausea and vomiting in the complications. The delayed discharge rate was 0.62%(34/5 520), the rate of unplanned readmission to hospital was 0.49%(27/5 520), and the satisfaction rate was 98.99%(5 464/5 520). ConclusionFor the above surgery types in this study, the day surgery mode is safe and effective.

    Release date:2021-06-24 01:08 Export PDF Favorites Scan
  • Lean management strategy of day surgery ward

    Objective To explore the effect of lean management on patients’ safety, medical quality, and satisfaction in day surgery ward. Methods The patients underwent day surgery between May 4th, 2017 and April 30th, 2018 were selected as the subjects (the lean management of day surgery ward implemented on November 1st, 2017). The patients underwent day surgery between May 4th and October 31st, 2017 were taken as the control group (n=2 864), and the ones between November 1st, 2017 to April 30th, 2018 were taken as the observation group (n=2 705). The following data between the two groups were compared: the cancellation rate of day surgery, the 24-hour delayed discharge rate, the rate of 12-hour median or severe pain after surgery, the rate of 12-hour postoperative nausea and vomiting, the awareness rate of health education, the patients’ satisfaction, and the incidence of adverse events.Results Compared with those in the control group, the cancellation rate of surgery (4.81% vs. 6.25%), the 24-hour delayed discharge rate (2.76% vs. 4.28%), the 12-hour median or severe pain after surgery (5.55% vs. 8.31%), the rate of 12-hour postoperative nausea and vomiting (5.86% vs. 7.71%) decreased in the observation group, and the differences were statistically significant (P<0.05). The awareness rate of health education increased from 92.18% to 98.02% after the implementation of lean management, the patients’ satisfaction increased from 92.48±2.58 to 96.53±1.64 after the implementation of lean management, and the differences were statistically significant (P<0.05). The incidences of adverse events in the two groups were not statistically different (0.16% vs. 0.41%, P>0.05). Conclusion The implementation of lean management model can insure the medical safety and quality of day surgery, and improve overall work efficiency and the patients’ medical service experience in day surgery ward.

    Release date:2019-02-21 03:19 Export PDF Favorites Scan
  • Establishment and management of day surgery center in general hospital

    Day surgery is one of the key tasks of the national medical reform. It is still in the stage of rapid developing in the country. It is the responsibility of the large general hospitals to explore the effective management mode of the day surgery center to meet the clinical quality and safety. During the establishment and management of day surgery center in general hospital, it is needed to build a strong specialized day surgery team through professional training, and to establish a coordination and incentive mechanism for the cooperation between the day ward and the specialized subjects by introducing lean thinking strategy. According to the characteristics of day surgery, the clinical pathway management and the whole course rehabilitation and the health education system of day surgery are established. The formulate norms for medical records of day surgery will be built. The monitoring system for the efficiency and safety of day surgery is established to improve the medical quality and safety of day surgery. As a result, the model of day surgery that conforms to the medical characteristics of China will be established.

    Release date:2019-02-21 03:19 Export PDF Favorites Scan
  • Analysis of the Causes of Delay Discharge Patients after Day Surgery in West China Hospital of Sichuan University

    ObjectiveTo analysis the reasons of delayed discharge in day surgery ward, so as to provide the basis for discharged quality monitoring of ambulatory surgery management. MethodsA retrospective survey was conducted on patients admitted in Department of Day Surgery Center of West China Hospital of Sichuan University from April 2012 to August 2014 after day surgery. The characteristics of patients classified as "delayed discharge patients" were described and the factors associated with delayed discharges were analyzed by using SPSS 19.0 software. ResultsA total of 14 560 patients were included, of which 81 patients were classified as "delayed discharge", and the rate of delayed discharge was 0.56% (81/14 560). Single disease delayed discharge rates were as follows: gallstone 2.13% (37/1 737), operation for varicose veins of lower limbs 1.91% (11/576), gastrointestinal polyps resection 0.33% (11/3 325), inguinal herniorrhaphy 0.63% (9/1 424), polyp of vocal cord resection 0.21% (4/1 879), breast package block minimally invasive resection 0.11% (2/1 761), choledochoscopy 0.06% (1/1 563) and other surgical 0.26% (6/2 295). No significant differences were found between the delayed discharge patients and normal discharge patients in age and gender (P>0.05). Compared with the normal discharge patients, there were significant differences in the four aspects of operation mode changes, postoperative complications, anesthesia factors and patient's own factors of delayed discharge patients (P<0.05). ConclusionThe changes of operation mode, postoperative complications, anesthesia factors and patient's own factors are related to the delay of hospital discharge. Strictly grasping the indications for ambulatory surgery and anesthesia patients, strengthening the admission education, letting the patients accept day surgery fully in psychological and preventing the possible complications and ensure the quality and safety after day surgery.

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  • 医疗纠纷调解处置对策与方法

    医疗纠纷是医院运行发展中一个难以回避的问题,军队医院也不例外。为防范疗纠纷,应从加强管理组织体系、强化医务人员法制观念、健全医疗规章制度、强化环节质量管理控制、实施责任追究制等方面采取一系列对策与措施,使医疗差错和医疗纠纷得以控制和降低;纠纷事件也可得到科学妥善处置,有力的促进了医院的建设发展和核心保障能力的提升。

    Release date:2021-06-23 07:35 Export PDF Favorites Scan
  • 日间手术模式接受意愿及满意度调查分析

    目的 调查日间手术患者对日间手术模式的接受意愿及其原因分析。 方法 采用问卷调查法,对2015年6月-8月日间手术的患者实施调查。由调查者于床旁亲自发放问卷,问卷当场回收。 结果 调查共发放问卷110份,回收有效问卷110份,有效率为100%。10例(9.1%)表示非常了解日间手术模式,34例(30.1%)表示了解日间手术模式,12例(10.7%)表示对日间手术模式了解一般,14例(12.5%)表示对日间手术模式不了解,40例(36.6%)表示对日间手术模式非常不了解。91例(82.7%)表示通过医生介绍知道日间手术模式的特点,28例(25.5%)通过亲朋好友的介绍了解一些日间手术模式的特点。98例(89.1%)表示通过住院知晓了日间手术模式的特点和相关信息,12例(10.9%)表示未获得日间手术模式的特点和相关信息。104例(94.5%)表示愿意接受日间手术模式。大部分患者愿意接受日间手术模式的原因是缩短了住院等候时间和治疗时间;不愿意接受日间手术模式的患者主要是担心出院后无医务人员的治疗和护理,影响术后的恢复。患者对就医过程、治疗效果、医护人员服务态度、出院指导均有较高的满意度,分别为96.4%、95.5%、99.1%和90.9%。 结论 日间手术模式是一种安全、快捷的手术模式,患者虽了解程度较低,但亲自体验后仍给予了高度认可。

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  • Study on indicator system of quality and safety of day surgery based on structure-process-outcome theory

    Since 2015, when the day surgery mode was officially reckoned and supported by the National Health Commission, the day surgery model has entered the new period of rapid development. But at the same time, challenges in the vacancy of the evaluation indexes of the medical quality and safety of day surgery still pose obstacles to its growth. At present, there is no nationally unified evaluating index or appraising system for the day surgery-related medical quality and safety. In this paper, based on structure-process-outcome theory, the day surgery practice and involved researching literature were retrieved, reviewed, and analyzed. Also, the practice model at West China Hospital of Sichuan University (a pioneer day surgery hospital in China) was comprehensively compared with the National Clinical Improvement System. From the aspect of day surgery medical quality and safety evaluation indicators, it is hoped to provide an evidence-based method and evaluation of day surgery, and a theoretical basis for establishing policies and data reference.

    Release date:2022-05-24 03:47 Export PDF Favorites Scan
  • 大型医院医疗安全预防两级监管体系浅析

    【摘要】 建立从上而下和从下而上两级医疗安全预防管理模式,是大型医院预防医疗不良事件的重要措施与保证。通过对医疗安全预防管理机制和运行效果的探讨及总结,阐明了两级监管体系在发现、化解、降低各种医疗纠纷隐患及医疗风险中的有效性和作用,可供其他医疗机构参考借鉴。

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • Exploration and practice of constructing medical risk management system based on SPO model

    ObjectiveTo provide a reference for the implementation of risk management in other medical institutions by introducing the practical experience of building a medical risk management system in West China Hospital of Sichuan University.MethodsBased on Donabedian’s SPO model, the practical experience in the construction of West China Hospital of Sichuan University was summarized from the aspects of structure, process, and results.ResultsThe establishment of medical risk management system made the hospital adverse event management effect good, and the risk management indicators were good. The average number of medical disputes in hospitals from 2016 to 2018 was 103.33, the average number of medical disputes per 100 medical practitioners was 7.01, the average number of medical disputes per 10 000 surgical cases was 6.55, and the average number of medical disputes per 10 000 cases was 0.18.ConclusionThe construction of medical risk management system is conducive to enhancing the awareness of medical risk prevention among medical institutions, continuously improving the quality of medical care and medical safety of hospitals, ensuring patient safety, promoting harmony between doctors and patients, and promoting the realization of healthy China.

    Release date:2019-06-25 09:50 Export PDF Favorites Scan
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