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临床领域的内部审计:卫生服务急诊科内部审计方法的试点

The internal audit of clinical areas: a pilot of the internal audit methodology in a health service emergency department.

作者信息

Brown Alison, Santilli Mario, Scott Belinda

机构信息

Australian Centre for Healthcare Governance, Melbourne, Australia.

East Grampians Health Service, Ararat, Australia.

出版信息

Int J Qual Health Care. 2015 Dec;27(6):520-2. doi: 10.1093/intqhc/mzv085. Epub 2015 Oct 13.

DOI:10.1093/intqhc/mzv085
PMID:26467893
Abstract

QUALITY PROBLEM OR ISSUE

Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data.

INITIAL ASSESSMENT

The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks.

CHOICE OF SOLUTION

Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks.

IMPLEMENTATION

The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines.

EVALUATION

The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management.

LESSONS LEARNED

The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings.

摘要

质量问题或议题

卫生服务的管理机构需要确保实现卫生服务目标的主要风险得到控制。目前,组织内部产生的主要保障机制是通过对政策和程序执行情况的审查以及对临床审计和质量数据的审查。

初步评估

卫生服务的管理机构需要更有力、客观的数据,以便了解临床风险的控制情况。

解决方案选择

内部审计提供了一个方法框架,可为管理机构提供有关重大风险控制的独立和客观保障。

实施

本文描述了在一家卫生服务机构的急诊科对内部审计方法进行的试点。一名内部审计员与一名临床专家合作,根据最佳实践指南评估临床标准的应用情况。

评估

临床领域内部审计试点成功识别出需要进一步管理的重大临床风险。

经验教训

将内部审计方法应用于临床领域是在治理层面就重大临床风险的管理获得有力保障的一种有前景的机制。这种方法需要在一系列医疗环境中进一步探索和试验。

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