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Objective:To analyze the hot spots complained by outpatients in a tertiary hospital, so as to provide a basis for improving patients′ medical experience and the quality of medical service and medical safety.Methods:The data were selected from the outpatient complaint information severity of a tertiary hospital from November 1, 2020 to April 30, 2021. Complaints were classified and graded with severity. The hot spots of erious plaints and high-risk hidden events were analyzed. The database was established by double entry method. The data were analyzed with descriptive statistic, and the correlation among variants was tested by chi-square.Results:A total of 4 160 valid complaints involving 6 340 questions were included. In terms of the complaint departments and problems, clinical departments(3 682, 88.51%) and environment problems(2 451, 38.66%) accounted for the highest proportions respectively. There was a correlation between the severity of complaint and medical treatment( P<0.001). The distributions of severe complaints in each type of problems were significantly different( P<0.001). In terms of severe complaints, listening and communication(62, 26.38%)accounted for the highest proportions. A total of 161 complaints were in line with definitions of " high-risk hidden incidents" , of which environment-related problems topped the rest, accounting for 45.24%. Conclusions:Outpatient complaints of the tertiary hospital mainly focused on the admission and diagnosis sectors of clinical departments, mostly on environment, listening and communication. In the future, the hospital should focus on optimizing the outpatient environment and establish an effective doctor-patient communication mechanism for better doctor-patient relationship, to avoid occurrence of high-risk hidden events, and improve both medical service quality and safety.
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The Medical Safety Committee has conducted various activities for patient safety in Japanese traditional Kampo medicines. In this study, we conducted a questionnaire survey to promote the prevention of medical accidents and their recurrence. We received responses from 15 of 19 facilities specializing in Kampo medicine and collected a total of 247 incident and accident cases in the field of Kampo medicine. Cases of side effects included interstitial pneumonia caused by Kampo prescriptions containing Scutellariae Radix, aconite poisoning, and licorice-induced pseudoaldosteronism. Furthermore, we also collected decoction-specific cases, which are unique to facilities specializing in Kampo medicine, for the first time. From the results, we included the following seven points for risk management in the field of Kampo medicine : 1) insufficient recognition to the side effects of Kampo medicines, 2) misunderstanding of the dosages of Kampo products, 3) errors due to similarities in Kampo formulas and crude drug names, 4) preconception of frequently used Kampo prescriptions, 5) contamination in the decoctions, 6) errors related to crude drug items and their dosages that are frequently added or subtracted, 7) errors in hospital wards.
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We collected and analyzed the case reports of minor incidents in the preparation of Kampo products in Japanese pharmacies in order to manage the medical safety control in Japanese traditional Kampo medicine. We extracted 2,166 reports that are related to Kampo products from the database of minor incidents in pharmacies supplied from The Japan Council for Quality Health Care from 2009 to 2019. Among the reports, we found the cases that pharmacists could find the mistakes about the name, dosage and administration of Kampo products or could prevent the appearance of adverse reaction when pharmacists check the prescription and ask prescription question for doctors. It is suggested that the system of separation of dispensing and prescribing functions would be well working in medical safety control. At the same time, we also found many cases that pharmacists have actually made mistakes by confusing the name of Kampo products and dosage. In this report, we summarized the cases of these minor incidents and frequently appearing confusions about the names of Kampo products.
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With the development of big data, the Internet and information technology, artificial intelligence is gradually being applied to the field of hospital management. The authors used advanced artificial intelligence technology to conduct structured collection and monitor the hospital′s current medical quality data, identifying key points and key events affecting medical quality and safety from the link, and providing medical personnel′s behavior with pre-warning, process monitoring and post-evaluation to improve hospital medical quality management.
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Medical security is a prominent problem in China,and the medical safety supervision system needs to be improved.Through the analysis of the existing literature,medical supervision process,current situation and problems are analyzed,and the medical supervision system in England is comparatively analyzed,and the relationship model of British regulators is built,the internal mechanism of British medical supervision is analyzed,and finally through combining with the actual situation of China,new ideas for perfecting the medical safety supervision are put forward.
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Objective To develop a new radial artery puncture fixing device to conquer the deficiencies of traditional method. Methods The device was composed of an arm support,a hand support,a wrist part,an arm fixing belt,a palm fixing belt and a tourniquet.The arm support was concave-shaped,and was connected with the hand support with the wrist part.The wrist part had a raised block which was gifted with an inflatable bag.The balloon linked with an inflation balloon with an inflation tube.There was a valve between the inflation tube and balloon.The fixing belt had one end directly connected with the arm support, hand support and wrist part, and the other end linked with the other ends of the above components with Velcro. There was a compression hemostatic balloon at the internal surface of the tourniquet. Results The device behaved well in puncture time and success rate,and decreased the incidence rates of errhysis and hematoma after withdrawing the puncture needle while increased the satisfaction of medical staffs and patients. Conclusion The device gains advantages in simple structure,convenience,practicability and safety,and meets the desired requirements.[Chinese Medical Equipment Jour-nal,2018,39(5):44-46]
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A functional reporting system for medical safety events is key to medical safety management. Based on a summary of the existing reporting system and a review of domestic and overseas literature, the hospital designed and put in use in the new campus a reporting system. Such a system is IT-based and task driven, covering such areas as medical service, pharmaceutical, equipment, blood transfusion, hospital acquired infection and logistics. Thanks to minimized approval formalities and use of task driven mode, this system can motivate the medical staff to report such events and improved their efficiency in handling them.
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Medical safety management and non-medical safety management are two major systems of hospital safety management.With the deepening of the medical and health system reform and the change of the mode of medical treatment,the connotation and extension of non medical safety management have changed,and the non-medical safety management field is faced with more risk factors and security risks.Combined with the.status quo of non medical safety management in hospital,the problems existing in non-medical safety management are analyzed and some suggestions for improvement are put forward.
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Objective To analyze the risk factors of the infusion pump to provide evidence-based basis for its safety management and monitoring.Methods Totally 1 000 pieces of questionnaires were issued for 100 infusion pumps from 9 grade-A tertiary hospitals in Beijing.The abnormalities and the correlation between the indexes were analyzed for the infusion pump,the indexes were compared on their effects on the abnormalities.Results Statistical analysis on data samples showed that the main factors included the manufacturer of infusion pump and pipeline,service time of infusion pump,compatibility between infusion pump and pipeline as well as the user department.Conclusion The management facility has to pose emphases on safety and utilization management as well as standardized application of the infusion pipeline so as to reduce adverse events efficiently.
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Objective To design an intelligent fire alarm system for the hospital ward.Methods The system was developed based on controller area network,and had its functions realized with intelligent detector,supplementary modules and intelligent controller,which had the functions of fire alarm,control and monitoring and consisted of the modules for SCM control,temperature acquisition,infrared detection,smoke detection,audible and visual alarm as well as display.Results The system facilitated the hospital in fire monitoring,audible and visual alarm so as to reduce the fire risks.Conclusion The system gains high reliability and practicability,and thus is worthy promoting practically.
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From the perspective of medical safety management, this paper states that it should foster the con-cept of medical safety, establish the goals of safety management, improve the safety management organization, and implement safety management and control measures. Furthermore, it analyzes several factors of doctors that influ-ence the doctor-patient relationship, which include hospital′s development direction and operation mode, the con-tradiction between the patient′s expectation and the limitation of medical technology, and the uncontrollable factors of medical development. Finally, it puts forward that the implementation of safety management is beneficial to en-hance the basic medical quality, decrease the medical errors, and improve the medical service level.
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OBJECTIVE:To provide reference for avoiding the recurrence of medical safety(adverse)events or inducing more severe medical accident. METHODS:The medical safety(adverse)events reported by a class A grade 3 hospital from July 2013 to March 2016 were studied retrospectively,and excluded purely adverse drug reactions and transfusion reactions to analyze the rea-son and characteristics. RESULTS:Of 747 events,there were 578 medical,nursing and drug-related medical safety (adverse) events,accounting for 77.38%;among 175 medical related medical safety(adverse)events,top 3 reasons were basic skills defi-ciencies,defects in the system processes,inadequate communication and education, accounting for 32.00%,24.00%,19.43%. The occurrence of medical safety (adverse) events were closely related to working life and qualifications;among 578 medical, nursing and drug-related medical safety (adverse) events,the incidence of adverse events was 71.11% in 5-year working life group,and that was 73.18% in junior titles group. CONCLUSIONS:Various professionals should strictly implement procedure and regulations,strengthen communication and education in daily work,and improve professional knowledge and skills so as to prevent the occurrence of adverse event completely.
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Objective To design a set of supply water processing system for disinfecting surgical instruments in integrated tertiary hospi-tal,and improve the quality of supply water for the instrument disinfection and control the cost of water. Methods Since October 2012,Wa-ter Disinfection Device for instrument in tertiary hospital CSSD was studied. And a system of integrated production and supply the softened wa-ter,level-one reverse osmosis purified water,secondary reverse osmosis pure water was designed,which can realize a steady supply of disinfec-tion water all the day. The equipment cleaning and instrument sterilization equipment running used softened water,final rinse and disinfection of equipment used level-one reverse osmosis water purification,the instrument sterilization with steam pressure for production used secondary reverse osmosis water purification. Results According to the design scheme,the equipment to supply and product water for integrated surgi-cal instruments disinfection was confirmed by processing water with specification,high efficiency and low cost for nearly three years,which sig-nificantly improved the quality of disinfection supply processing of the surgical instrument. Conclusion Only Focus on supply water for sur-gical instruments disinfection in the tertiary hospital,and improve the quality of the equipment disinfection supplies, which could provide se-curity for clinical medical treatment of sterile equipment.
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Put forward opinions and suggestions about characteristics of the new era of medical disputes pre -vention treatment through the analysis of a hospital in the past five years occurred in 44 medical disputes .We must fo-cus on innovation and long -term mechanism to prevent medical malpractice , medical malpractice to further improve the prevention, comprehensive mechanism , and continuously improve the effectiveness of medical dispute processing services.
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Objective To analyze characters and causes of medical safety (adverse) events and to propose corresponding countermeasures.Methods 322 medical safety events in some tertiary hospitals were analyzed by using the root causes analysis method.Results Identifying errors,medical defects,medicine mistakes were the top 3 events possessed 16.77％ (54/322),16.15％ (52/322),13.98％ (45/322);The top 3 departments were Neurology,General surgery,Oncology which possessed 9.63％ (31/322),7.45％ (24/322),7.14％ (23/322).Medical staff with a title of middle and highly were involved in possessed 33.23％ (107/322),25.78％ (83/322),and nursing staff was the top one possessed 56.83％ (183/322).Night working shift was the maximum occurrence time possessed 39.75％ (128/322).The top 3 medical acts which more easier to trigger medical adverse events were incomprehensive nursing care,irregular operation of diagnosis and treatment,clinical supervision defect which possessed 17.39％ (56/322),15.84％ (51/322),15.22％ (49/322).The slight consequence case was the top one possessed 47.20％ (152/322).Resolving the dispute by consultation between hospital and patient was the main way possessed 82.26％ (51/62).Conclusions More attentions should be paied to supervision of some certain department management and key sections,and improve the professional technical level,do preventive construction systems about medical safety (adverse) as well as emergency event handling construction mechanism by consummate supporting system and effective staff arrangement.
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Quality assessment in primary care is increasingly important, and quality indicators of primary care principles and primary care physicians' tasks are available for policy making and quality improvement in other countries. Patient centeredness is an especially important concept for evaluation of primary care principles, so patient experience surveys using quality assessment tools have been conducted in Europe and the US. On the other hand, similar effective approaches are lacking in Japan. Previous studies have indicated that important primary care principles in Japan are accessibility, comprehensiveness, coordination, longitudinal continuity, interpersonal continuity, community oriented care, and family oriented care. Quality assessment and assurance from multiple aspects should be promoted in the future to improve the quality of primary care in Japan.
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This article sumarized a practise-based study of the hospital regarding the management of its medical activities.By means of priotizing medical safety in pre-job and on-the-job eduation,and regular trainings in this regard,a systemized medical safety education ssytem is put in place among medical staff of different types and levels.This achieved the purpose of higher awaress of medical safety in medical practice,and downsized medical complaints significantly.
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Quality management covers every corner of hospital services,which upholds full-process quality management,continuous quality improvement and smooth management with patients at the center.By means of building a 3-tier quality management framework at the hospital,development of quality management criteria,appraisal indicators and documentation and use of quality management tools,quality management defects were identified from a third-party perspective.This effort has significantly improved quality of care at the hospital,and elevated the management execution and general service quality of the hospital.
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Quality of care is key to medical safety which has a close bearing on patients’life and health,and on the branding and efficiency of the hospital.Medical safety is one of the key indicators of the overall performance appraisal of the hospital.This novel type of nurse-physician collaboration,abandoning the traditional model of health care,is a new integrated model of health care which improves the overall quality of care,enhances medical safety and patient satisfaction.This paper described in detail the implementation methods and steps of the collaboration,the progress of such a collaboration and its contribution to medical safety are also discussed.
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The hospital observed the principles of ensuring medical safety,shared risks and responsibilities in its attempt to build the risk mortgage mechanism in the hospital.The mechanism is characteristic of setting up the scope and standards for the risk mortgage,defining the use and refund cycle of the risk mortgage,along with a series of rewards and penalties.This design aims at minimizing cases of medical disputes (malpractice) for better medical safety.