目的 探讨风险管理在医院感染管理中的应用与效果。 方法 以风险管理知识为指导，通过分析医院感染管理工作中存在或潜在的医院感染风险制订风险管理预防，指导临床规避和化解感染风险，确保医疗安全。 结果 风险管理的实施提高了医院感染管理质量，减少了医院感染的发生。 结论 风险管理在医院感染管理中的应用不仅可以降低医院感染的风险，也提高了医疗质量。Objective To investigate the application of risk management in hospital infection control and its effect. Methods Guided by risk-management knowledge, we analyzed the potential infection risks in hospital infection control work and regulated risk management policies, in order to avoid and defuse the risk of infection and ensure medical safety. Result The implementation of risk management improved the quality of hospital infection control, and reduced the incidence of hospital infections. Conclusion Risk management in hospital infection control can not only reduce the risk of infection, but also improve the quality of care.
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.
摘要:医院有效事前监测、管控医疗不良事件，是保障患者安全、提高医疗质量的管理措施之一。超大型医院对医疗不良事件管理的实战中，建立、实施医疗安全隐患事件关键监测指标、医疗安全隐患事件筛查程序指标，积极开展医疗不良事件后台监管工作，切断医疗安全隐患事件向医疗风险事件演变、医疗风险事件向医疗纠纷事件演变的环节，保障患者安全。Abstract: Effective supervision in advance to the medical adverse event, is one of measures which hospital adopt to guarantee patient safety and enhance medical quality. The actual combat of supervision to the medical adverse event in super sized hospital, set up and put in practice on the key target of supervising the medical adverse event and the key target of ridding procedure, remain in the background and work actively on supervision on the medical adverse event, shut off the road from the medical safety issue to the medical risk issue and the road from the medical risk issue to the medical dissension in order to guarantee the patient safety.
Day surgery is a new medical service model, which has developed rapidly in China because of its advantages of safety, efficiency and resource conservation. However, along with the rapid development in quantity, it also presents contradictions such as the mismatch with the previous surgical quality and safety management model, the urgent need for the unification of the new system of quality and safety evaluation indicators at the national level, and the imbalance in the construction of information technology of medical institutions in China, leading to the new problem of uneven quality control of day surgery. This article constructs a “five-in-one” new system for the quality and safety management of day surgery from the perspective of high-quality development, aiming to provide a theoretical basis for the formulation of relevant policies in China and to promote the safe, efficient, and orderly development of day surgeries.
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.
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.
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.