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英国国民医疗服务体系(NHS)东英格兰地区的信任级别风险识别指南。

Trust-level risk identification guidance in the NHS East of England.

作者信息

Simsekler M C Emre, Card Alan J, Ward James R, Clarkson P John

机构信息

University College London, Department of Management Science and Innovation, London, UK.

Evidence-Based Health Solutions, LLC, Notre Dame, IN, USA.

出版信息

Int J Risk Saf Med. 2015;27(2):67-76. doi: 10.3233/JRS-150651.

Abstract

BACKGROUND

In healthcare, a range of methods are used to improve patient safety through risk identification within the scope of risk management. However, there is no evidence determining what trust-level guidance exists to support risk identification in healthcare organisations. This study therefore aimed to determine such methods through the content analysis of trust-level risk management documents.

METHOD

Through Freedom of Information Act, risk management documents were requested from each acute, mental health and ambulance trust in the East of England region of NHS for content analysis. Received documents were also compared with guidance from other safety-critical industries to capture differences between the documents from those industries, and learning points to the healthcare field.

RESULTS

A total of forty-eight documents were received from twenty-one trusts. Incident reporting was found as the main method for risk identification. The documents provided insufficient support for the use of prospective risk identification methods, such as Prospective Hazard Analysis (PHA) methods, while the guidance from other industries extensively promoted such methods.

CONCLUSION

The documents provided significant insight into prescribed risk identification practice in the chosen region. Based on the content analysis and guidance from other safety-critical industries, a number of recommendations were made; such as introducing the use of PHA methods in the creation and revision of risk management documents, and providing individual guidance on risk identification to promote patient safety further.

摘要

背景

在医疗保健领域,一系列方法被用于在风险管理范围内通过风险识别来提高患者安全。然而,尚无证据表明存在何种信任级别指南来支持医疗保健机构中的风险识别。因此,本研究旨在通过对信任级别风险管理文件的内容分析来确定此类方法。

方法

通过《信息自由法》,向英国国民医疗服务体系(NHS)英格兰东部地区的每个急症、心理健康和救护车信托机构索取风险管理文件进行内容分析。收到的文件还与其他安全关键行业的指南进行了比较,以找出这些行业文件之间的差异以及对医疗保健领域的借鉴点。

结果

从21个信托机构共收到48份文件。事件报告被发现是风险识别的主要方法。这些文件对前瞻性风险识别方法(如前瞻性危害分析(PHA)方法)的使用支持不足,而其他行业的指南广泛推广此类方法。

结论

这些文件对所选地区规定的风险识别实践提供了重要见解。基于内容分析和其他安全关键行业的指南,提出了一些建议;例如在创建和修订风险管理文件时引入PHA方法的使用,并提供关于风险识别的个别指南以进一步促进患者安全。

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