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奥地利医院的发病率和死亡率会议实施情况——一项全国横断面调查研究。

Implementation status of morbidity and mortality conferences in Austrian hospitals-A cross-sectional national survey study.

机构信息

Research Unit for Safety in Health, c/o Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.

Swiss Patient Safety Foundation Zurich, Zürich, Switzerland.

出版信息

PLoS One. 2021 Mar 17;16(3):e0248692. doi: 10.1371/journal.pone.0248692. eCollection 2021.

Abstract

INTRODUCTION

Morbidity and mortality conferences (M&MCs) are an instrument for learning from past complications, unexpected follow-ups and deaths in hospitals and are important for improving patient safety. However, there are currently no quantitative data on the implementation of M&MCs in Austria. The aim of the study was to determine the status quo of the M&MCs in Austria.

MATERIALS AND METHODS

A national cross-sectional study was conducted by means of a survey of 982 chief physicians of surgical disciplines, internal medicine, anesthesiology, intensive care, gynecology/obstetrics and pediatrics. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs.

RESULTS

Of the 982 contacted chief physicians, 314 (32.0%) completed the survey. Almost two thirds of the respondents, i.e. 203 (64.7%), had already implemented M&MCs. Of the 111 chief physicians who had not yet introduced M&MCs, 62 (55.9%) were interested in introducing such conferences in the future. Of the 203 respondents that had implemented M&MCs, 100 stated that their M&MC could be improved. They reported issues with "shame and blame" culture, hierarchical structures, too little knowledge about the capability of M&MC and, in particular, time constraints. Overall, the participating chief physicians showed that they are striving to improve their existing M&MCs.

DISCUSSION/CONCLUSION: While we found a relatively high number of already implemented M&MCs we also identified a large heterogeneity in the format of the M&MCs. A highly structured M&MC including guidelines, checklists or templates does not only considerably improve its outcome but can also alleviate the main limiting factor which is the lack of time.

摘要

简介

发病率和死亡率会议(M&MC)是从医院过去的并发症、意外随访和死亡中学习的工具,对于提高患者安全性非常重要。然而,目前奥地利没有关于 M&MC 实施情况的定量数据。本研究旨在确定奥地利 M&MC 的现状。

材料和方法

通过对 982 名外科、内科、麻醉科、重症监护、妇科/产科和儿科首席医师进行的一项全国性横断面调查,开展了一项全国性的横断面研究。该问卷侧重于医院 M&MC 的总体目标、结构和程序。

结果

在联系的 982 名首席医师中,有 314 名(32.0%)完成了调查。近三分之二的受访者,即 203 名(64.7%)已经实施了 M&MC。在尚未引入 M&MC 的 111 名首席医师中,有 62 名(55.9%)有兴趣在未来引入此类会议。在实施了 M&MC 的 203 名受访者中,有 100 名表示他们的 M&MC 可以改进。他们报告了“羞耻和责备”文化、等级结构、对 M&MC 能力的了解不足以及时间限制等问题。总的来说,参与调查的首席医师表明,他们正在努力改进现有的 M&MC。

讨论/结论:尽管我们发现已经实施的 M&MC 数量相对较多,但我们也发现 M&MC 的格式存在很大的异质性。一个高度结构化的 M&MC 包括指南、检查表或模板,不仅可以显著提高其结果,还可以缓解主要的限制因素,即缺乏时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b19/7968694/c4ba87b4e5f1/pone.0248692.g001.jpg

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