Pfenninger E, Güzelel H
Stabsstelle Katastrophenschutz, Universitätsklinikum Ulm, Albert-Einstein-Allee 29, 89081, Ulm, Deutschland.
Chirurgischer Zentral-OP, Universitätsklinikum Ulm, Ulm, Deutschland.
Anaesthesist. 2017 Jun;66(6):431-441. doi: 10.1007/s00101-017-0281-9.
According to legal regulations alarm and emergency plans have to be developed and kept current in hospitals. However, often neither the hospital administration, nor the medical employees and nursing staff pay the necessary attention to these alarm and evacuation plans. In particular, risks and consequences - including financial ones - due to insufficient planning, are not adequately considered.
Risks in hospitals are assessed based on a risk analysis. The risk assessment evaluates, whether the risk is acceptable, critical or unacceptable. Parameters for the risk analysis are the magnitude of damage and number of affected people. The intention of this paper is to evaluate whether there is a connection between estimated risk, quality of risk planning, and financial damage.
We visualized the risk analysis as a two-dimensional matrix. In addition, we introduced disaster planning quality as a third dimension and calculated the dependency between risk and planning quality and also between the resulting damage level and the planning quality.
We showed that a poor disaster planning quality increases the unacceptable risk exponentially. Risk assessment can also draw conclusions about the extent of financial damage caused, for example fires, terrorist attacks or infrastructure failure. The amount of damage can be described as a function depending on the planning deficit of emergency planning. The worse the planning quality, the higher the amount of damages for non-tolerable risks can be.
Risk management means recognizing risks, assessing risks and managing risks. In hospitals, this mostly means using a critical incident reporting system (CIRS), however risk management in the sense of disaster planning is largely unknown. With a three-dimensional risk matrix, we showed a clear correlation between the quality of disaster planning and relative risk or financial damage. To substantiate the presented theoretical considerations, however, further research must be designed and implemented.
根据法律法规,医院必须制定并更新警报和应急预案。然而,医院管理层、医务人员和护理人员往往都没有对这些警报和疏散计划给予必要的关注。特别是,由于规划不足所带来的风险和后果,包括财务方面的,都没有得到充分考虑。
基于风险分析评估医院中的风险。风险评估用于评估风险是可接受的、关键的还是不可接受的。风险分析的参数是损害程度和受影响人数。本文旨在评估估计风险、风险规划质量和财务损害之间是否存在关联。
我们将风险分析可视化为二维矩阵。此外,我们引入灾难规划质量作为第三个维度,并计算风险与规划质量之间以及由此产生的损害水平与规划质量之间的相关性。
我们表明,糟糕的灾难规划质量会使不可接受风险呈指数级增加。风险评估还可以推断出例如火灾、恐怖袭击或基础设施故障等所造成的财务损害程度。损害金额可以描述为一个取决于应急规划不足的函数。规划质量越差,不可容忍风险的损害金额就越高。
风险管理意味着识别风险、评估风险和管理风险。在医院中,这主要意味着使用关键事件报告系统(CIRS),然而从灾难规划意义上讲的风险管理在很大程度上并不为人所知。通过三维风险矩阵,我们展示了灾难规划质量与相对风险或财务损害之间存在明显的相关性。然而,为了证实所提出的理论考量,必须设计并实施进一步的研究。