Campillo-Artero C
Subdirección de Evaluación Asistencial, Servei de Salut de les Illes Balears, Palma de Mallorca, España.
Rev Calid Asist. 2012 Jul-Aug;27(4):233-9. doi: 10.1016/j.cali.2011.07.004. Epub 2012 Jun 29.
Patient safety is becoming commonplace in management contracts. Since our experience in patient safety still falls short of other clinical areas, it is advisable to review some of its characteristics in order to improve its inclusion in these contracts. In this paper opinions and recommendations concerning the design and review of contractual clauses on safety are given, as well as reflections drawn from methodological papers and informal opinions of clinicians, who are most familiar with the nuances of safe and unsafe practices. After reviewing some features of these contracts, criteria for prioritizing and including safety objectives and activities in them, and key points for their evaluation are described. The need to replace isolated activities by systemic and multifaceted ones is emphasized. Errors, limitations and improvement opportunities observed when contracts are linked to indicators, information and adverse event reporting systems are analysed. Finally, the influence of the rules of the game, and clinicians behaviour are emphasised.
患者安全在管理合同中日益普遍。鉴于我们在患者安全方面的经验仍不及其他临床领域，为了更好地将其纳入这些合同，有必要审视其一些特点。本文给出了有关安全合同条款设计与审查的意见和建议，以及从方法学论文和最熟悉安全与不安全操作细微差别的临床医生的非正式意见中得出的思考。在审视了这些合同的一些特征后，描述了在合同中确定安全目标和活动优先级及纳入其中的标准，以及评估这些目标和活动的关键点。强调了用系统性和多方面的活动取代孤立活动的必要性。分析了合同与指标、信息及不良事件报告系统挂钩时所观察到的错误、局限性和改进机会。最后，强调了游戏规则和临床医生行为的影响。
