Guédon Annetje C P, Wauben Linda S G L, van der Eijk Anne C, Vernooij Alex S N, Meeuwsen Frédérique C, van der Elst Maarten, Hoeijmans Vivian, Dankelman Jenny, van den Dobbelsteen John J
Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Surg Endosc. 2016 Jul;30(7):2728-35. doi: 10.1007/s00464-015-4537-7. Epub 2015 Oct 20.
Unavailability of instruments is recognised to cause delays and stress in the operating room, which can lead to additional risks for the patients. The aim was to provide an overview of the hazards in the entire delivery process of surgical instruments and to provide insight into how Information Technology (IT) could support this process in terms of information availability and exchange.
The process of delivery was described according to the Healthcare Failure Mode and Effects Analysis methodology for two hospitals. The different means of information exchange and availability were listed. Then, hazards were identified and further analysed for each step of the process.
For the first hospital, 172 hazards were identified, and 23 of hazards were classified as high risk. Only one hazard was considered as 'controlled' (when actions were taken to remove the hazard later in the process). Twenty-two hazards were 'tolerated' (when no actions were taken, and it was therefore accepted that adverse events may occur). For the second hospital, 158 hazards were identified, and 49 of hazards were classified as high risk. Eight hazards were 'controlled' and 41 were 'tolerated'. The means for information exchange and information systems were numerous for both cases, while there was not one system that provided an overview of all relevant information.
The majority of the high-risk hazards are expected to be controlled by the use of IT support. Centralised information and information availability for different parties reduce risks related to unavailability of instruments in the operating room.
手术器械供应不足被认为会导致手术室出现延误和压力，进而给患者带来额外风险。目的是概述手术器械整个交付过程中的危害，并深入了解信息技术（IT）如何在信息可用性和交换方面支持这一过程。
根据医疗失效模式与效应分析方法描述了两家医院的交付过程。列出了不同的信息交换和可用性方式。然后，识别并进一步分析了该过程每个步骤中的危害。
对于第一家医院，识别出172项危害，其中23项危害被归类为高风险。只有一项危害被视为“已控制”（在过程后期采取行动消除危害时）。22项危害被“容忍”（未采取任何行动，因此接受可能发生不良事件）。对于第二家医院，识别出158项危害，其中49项危害被归类为高风险。8项危害被“控制”，41项被“容忍”。两种情况下的信息交换方式和信息系统都很多，但没有一个系统能提供所有相关信息的概述。
预计大多数高风险危害将通过使用IT支持来控制。为不同方提供集中信息和信息可用性可降低与手术室器械供应不足相关的风险。
