Institute of Anaesthesia and Intensive Care, Hirslanden Clinic, Zurich, Switzerland.
Curr Opin Anaesthesiol. 2020 Dec;33(6):815-822. doi: 10.1097/ACO.0000000000000930.
Recent research points to considerable rates of preventable perioperative patient harm and anaesthesiologists' concerns about eroding patient safety. Anaesthesia has always been at the forefront of patient safety improvement initiatives. However, factual local safety improvement requires local measurement, which may be afflicted by barriers to data collection and improvement activities. Because many of these barriers are related to mandatory reporting, the focus of this review is on measurement methods that can be used by practicing anaesthesiologists as self-improvement tools, even independently from mandatory reporting, and using basic techniques widely available in most institutions.
Four mutually complementary measurement approaches may be suited for local patient safety learning: incident and rate-based measurements, staff surveys and patient surveys. Reportedly, individual methods have helped to tailor problem solutions and to reduce patient harm, morbidity, and mortality.
Considering the potential for perioperative patient safety measurements to improve patient outcomes, the absence of a generally accepted measurement standard and manifold barriers to reporting, a pragmatic approach to locally measuring patient safety appears advisable.
最近的研究表明，围手术期可预防的患者伤害发生率相当高，麻醉师对患者安全受到侵蚀表示担忧。麻醉学一直处于患者安全改进措施的前沿。然而，实际的本地安全改进需要本地测量，这可能受到数据收集和改进活动障碍的影响。由于这些障碍中有许多与强制性报告有关，因此本综述的重点是可以由执业麻醉师用作自我改进工具的测量方法，即使不依赖强制性报告，并且使用大多数机构都广泛提供的基本技术。
有四种相互补充的测量方法可能适用于本地患者安全学习：基于事件和比率的测量、员工调查和患者调查。据报道，个别方法有助于针对问题制定解决方案并减少患者伤害、发病率和死亡率。
考虑到围手术期患者安全测量可能改善患者结局，以及缺乏普遍接受的测量标准和报告的多种障碍，采用务实的方法进行本地患者安全测量似乎是明智的。
