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提高儿童死亡概述小组的实践:儿科视角。

Improving the practice of child death overview panels: a paediatric perspective.

机构信息

Department of Medicine, Royal Cornwall Hospital, , Truro, Cornwall, England.

出版信息

Arch Dis Child. 2014 Mar;99(3):193-6. doi: 10.1136/archdischild-2013-305085. Epub 2013 Nov 19.

Abstract

OBJECTIVE

In England, every death in childhood is reviewed by a local multidisciplinary Child Death Overview Panel (CDOP) with the intention of understanding causation and implementing interventions to reduce future deaths. This study aimed to establish how well panels work from the perspective of the paediatricians involved and to ascertain whether they deliver good value and identify areas for improvement.

DESIGN

A questionnaire was sent to every CDOP paediatrician in the country (n=93). Questions focused on the quality of CDOP case discussions as well as examples of effective and significant recommendations. Responses were analysed using simple quantitative and qualitative methods.

RESULTS

84/93 (90%) of the paediatricians responded. Among the respondents, 60 (71%) believe that investment in CDOPs is offering good value, 73 (87%) feel that case discussions are rigorous and consistent and over 90% believe that the correct issues are emerging from discussions. However, responders noted many areas for improvement: 40 (48%) suggested devolving the discussion of specialist deaths (eg, neonates) to hospital-based review meetings or holding themed meetings with invited specialists, 11 (13%) suggested filtering out cases where learning is unlikely before full CDOP meetings and 13 (15%) called for national integration and analysis of data.

CONCLUSIONS

In this time of economic austerity it is vital that the CDOPs add value to the invested resources. Although CDOP paediatricians feel that panels are working well, there is scope for improvement through enhancing relationships with commissioning bodies, aggregate review and analysis of CDOP data at a national level and consideration of specialist and/or network review of certain categories of deaths such as cardiac surgery, oncology and neonates.

摘要

目的

在英国,每一例儿童死亡都会由当地多学科儿童死亡概述小组(CDOP)进行审查,目的是了解死因并实施干预措施以减少未来的死亡。本研究旨在从参与的儿科医生的角度评估小组的工作效果,并确定其是否具有良好的价值并发现改进的领域。

设计

向全国每一位 CDOP 儿科医生(n=93)发送了一份问卷。问题集中在 CDOP 病例讨论的质量以及有效和重要建议的示例上。使用简单的定量和定性方法分析了答复。

结果

93 名儿科医生中有 84 名(90%)做出了回应。在答复者中,60 名(71%)认为 CDOP 投资具有良好的价值,73 名(87%)认为病例讨论严谨且一致,超过 90%的人认为正确的问题正在从讨论中浮现。但是,答复者注意到许多改进的领域:40 名(48%)建议将专家死亡(例如新生儿)的讨论下放到医院审查会议或举行邀请专家参加的主题会议,11 名(13%)建议在进行全面 CDOP 会议之前过滤掉不太可能从中学习的病例,13 名(15%)呼吁进行全国范围内的数据整合和分析。

结论

在当前经济紧缩时期,CDOP 必须为投入的资源增加价值。尽管 CDOP 儿科医生认为小组运作良好,但通过加强与委托机构的关系、汇总审查和分析全国范围内的 CDOP 数据以及考虑对某些类别的死亡(如心脏手术、肿瘤学和新生儿)进行专家和/或网络审查,可以进一步提高小组的工作效果。

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