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患者安全框架

Framework for Patient Safety.

作者信息

Mohiuddin A K

机构信息

Department of Pharmacy, World University of Bangladesh, Bangladesh.

出版信息

Innov Pharm. 2019 Aug 31;10(1). doi: 10.24926/iip.v10i1.1637. eCollection 2019.

Abstract

A commitment on quality objectives is a crucial element of quality policy in HROs, such as hospitals and other healthcare institutions. The quality of care includes objectives related to effectiveness, efficiency, and a patient's experience. Healthcare organizations are also aware of the importance of promoting safety practices and the resiliency analysis of the clinical practice in order to improve quality. Patient Safety Culture has been defined as the product of individual and group values, attitudes, competencies, and patterns of behavior that determines their commitment, style, and proficiency with the organization's health and safety programs. The safety culture of a health center offers an indirect means for its involvement in quality. Poor involvement of professionals in safety has negative consequences for patients. Envisioning the future of patient safety is more than an academic exercise. Appealing visions can help channel human energies, set new directions, and open the doors to alternative approaches. An outside observer is struck by three characteristics that are very different from the culture of the early 21st century: a deep sense of individual and institutional accountability for safety, an emphasis on fairness and transparency, and pervasive collaboration and teamwork based on mutual respect. Speaking up is important for patient safety, but healthcare professionals often hesitate to voice their concerns. Direct supervisors have an important role in influencing speaking up. However, good insight into the relationship between managers' behavior and employees' perceptions about whether speaking up is safe and worthwhile is still lacking. The evaluation should cover the following areas in both instruments: strategy (inquiry on their commitment to the quality and safety strategy, indicators' feedback, and risks maps), support systems for clinical decisions (digital record algorithms to make decisions and for accessibility to patient clinical information), equipment (adequacy), follow-up (availability of tests when needed), person-centered care (respect of patients' values and preferences), evidence-based practice (practices in accordance with guidelines), delays (on scheduled tests, surgery, and outpatient care), and cost-effective treatments (adequacy).

摘要

对质量目标的承诺是医院等医疗保健机构(HROs)质量政策的关键要素。护理质量包括与有效性、效率和患者体验相关的目标。医疗保健组织也意识到促进安全实践以及对临床实践进行弹性分析以提高质量的重要性。患者安全文化被定义为个人和群体的价值观、态度、能力以及行为模式的产物,这些决定了他们对组织健康和安全计划的承诺、风格和熟练程度。健康中心的安全文化为其参与质量提供了一种间接方式。专业人员对安全的参与度低会给患者带来负面影响。展望患者安全的未来不仅仅是一项学术活动。有吸引力的愿景有助于引导人力、设定新方向并为替代方法打开大门。外部观察者会被三个与21世纪初文化截然不同的特征所打动:对安全有深刻的个人和机构责任感、强调公平和透明度以及基于相互尊重的广泛协作和团队合作。直言不讳对患者安全很重要,但医疗保健专业人员往往犹豫是否表达他们的担忧。直接上级在影响直言不讳方面起着重要作用。然而,对于管理者行为与员工对直言不讳是否安全和值得的看法之间的关系,仍缺乏深入了解。两种工具的评估都应涵盖以下方面:战略(询问他们对质量和安全战略的承诺、指标反馈和风险地图)、临床决策支持系统(用于决策和获取患者临床信息的数字记录算法)、设备(充足性)、随访(需要时测试的可用性)、以患者为中心的护理(尊重患者的价值观和偏好)、循证实践(符合指南的实践)、延误(预定测试、手术和门诊护理方面)以及成本效益治疗(充足性)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79eb/7643696/0128062ab796/21550417-10-01-1637-g1.jpg

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