Slany E, Reuter W, Thüsing C, Schmidt C E
Aus der Deutschen Krankenversicherung AG, Leistungsmanagement, Medizinische Beratung, Köln.
Versicherungsmedizin. 2011 Dec 1;63(4):180-5.
Medical advances in diagnosis and therapy, especially in medical technology, lead to differenciated and more complex strategies in therapy with higher risks. Patients show higher expectations concerning the results of a therapy and claim more often that a mistake in treatment has been made. This makes patients turn to arbitration boards more often. They may also want to bring civil action against physicians and hospitals, claiming for compensation and damages. Personal liability insurances have to pay more for damages. Medical insurances have more recourse demands due to mistake in treatment. Hospital and especially operative medicine do have high chances of risks and mistakes. The implementation of a modern risk management system in the hospitals is becoming more and more important, for patients as well as for the surgical departments. A structured reporting system of critical incidents can produce indicators of potential sources of mistakes, which appears to be a successful approach to reduce or avoid typical risks and mistakes in medical treatment. Risk management in medical treatment must be more than just a trendy word, because its roots are in the medical principles of "primum nihil nocere". It is a challenge to today's and tomorrow's medicine. This article is a general overview of current strategies for avoiding mistakes: It is meant to be the basis of a new culture of mistake avoidance as a part of a future quality competition.
诊断和治疗方面的医学进步，尤其是医疗技术的进步，导致治疗策略更加差异化和复杂，风险也更高。患者对治疗结果的期望更高，并且更频繁地声称治疗存在失误。这使得患者更频繁地求助于仲裁委员会。他们还可能想对医生和医院提起民事诉讼，要求赔偿和损害赔偿。个人责任保险不得不支付更多的损害赔偿金。医疗保险因治疗失误而面临更多的追索要求。医院，尤其是外科手术，存在较高的风险和失误几率。对医院而言，无论是对患者还是对外科部门，实施现代风险管理系统正变得越来越重要。关键事件的结构化报告系统可以生成潜在失误源的指标，这似乎是减少或避免医疗中典型风险和失误的一种成功方法。医疗中的风险管理绝不仅仅是一个时髦的词汇，因为它源于“首要不伤害”的医学原则。它是当今和未来医学面临的一项挑战。本文是对当前避免失误策略的总体概述：它旨在成为作为未来质量竞争一部分的新的避免失误文化的基础。
