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医院临床风险管理系统评估:一种质量改进方法

Assessment of Clinical Risk Management System in Hospitals: An Approach for Quality Improvement.

作者信息

Farokhzadian Jamileh, Dehghan Nayeri Nahid, Borhani Fariba

机构信息

.

出版信息

Glob J Health Sci. 2015 Mar 18;7(5):294-303. doi: 10.5539/gjhs.v7n5p294.

Abstract

BACKGROUND

Clinical risks have created major problems in healthcare system such as serious adverse effects on patient safety and enhancing the financial burden for the healthcare. Thus, clinical risk management (CRM) system has been introduced for improving the quality and safety of services to health care. The aim of this study was to assess the status of CRM in the hospitals.

METHODS

A cross-sectional study was conducted on 200 nursing staff from three teaching hospitals affiliated with the Kerman University of Medical Sciences in southeast of Iran. Data were collected from the participants using questionnaire and observational checklist in quality improvement offices and selected wards. The data were analyzed using SPSS version 20.

RESULTS

Almost, 57% of persons participated in at least one of training sessions on CRM. The status of CRM system was rated from weak to moderate (2.93±0.72- 3.18±0.66). Among the six domains of CRM system, the highest mean belonged to domain the monitoring of analysis, evaluation and risk control (3.18±0.72); the lowest mean belonged to domain the staff's knowledge, recognition and understanding of CRM (2.93±0.66). There were no integrated electronic systems for recording and analyzing clinical risks and incidents in the hospitals.

CONCLUSION

Attempts have been made to establish CRM through improvement quality approach such as clinical governance and accreditation, but not enough, however, health care should move toward quality improvement and safe practice through the effective integration of CRM in organizational process.

摘要

背景

临床风险给医疗系统带来了重大问题,如对患者安全产生严重不良影响,并增加了医疗保健的经济负担。因此,引入了临床风险管理(CRM)系统以提高医疗服务的质量和安全性。本研究的目的是评估医院中CRM的现状。

方法

对伊朗东南部克尔曼医科大学附属的三所教学医院的200名护理人员进行了横断面研究。通过问卷调查和在质量改进办公室及选定病房使用观察清单从参与者那里收集数据。使用SPSS 20版对数据进行分析。

结果

几乎57%的人员参加了至少一次关于CRM的培训课程。CRM系统的现状被评为从弱到中等(2.93±0.72 - 3.18±0.66)。在CRM系统的六个领域中,平均得分最高的属于分析、评估和风险控制监测领域(3.18±0.72);平均得分最低的属于员工对CRM的知识、认知和理解领域(2.93±0.66)。医院中没有用于记录和分析临床风险及事件的综合电子系统。

结论

已尝试通过临床治理和认证等质量改进方法来建立CRM,但还不够,然而,医疗保健应通过将CRM有效整合到组织流程中朝着质量改进和安全实践迈进。

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