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[德国医院临床风险管理的发展]

[Development of clinical risk management in German hospitals].

作者信息

Bartz Hans-Jürgen

机构信息

Geschäftsbereich Qualitätsmanagement und klinisches Prozessmanagement, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2022 Mar;65(3):293-301. doi: 10.1007/s00103-022-03491-5. Epub 2022 Feb 8.

Abstract

Clinical risk management supports healthcare workers in recognizing, reducing, and managing risks in patient care. It is mandatory for all outpatient and inpatient facilities in the German healthcare system. The contents of the clinical risk management are regulated in the Social Code (Title 5), the guidelines of the Federal Joint Committee, the Patients' Rights Act, and the norms and recommendations of the Patient Safety Alliance. The Federal Joint Committee explicitly points out that minimum standards of risk management, error management, error reporting systems, complaint management in hospitals, and the use of checklists for surgical interventions must be implemented.The legislator requires that the effectiveness of the clinical risk management be checked regularly. Questionnaire surveys on clinical risk management in Germany show an overall positive development. However, the data are not sufficient for a comprehensive assessment. Methodologically reliable procedures should therefore be developed that check the status of the clinical risk management much more frequently and regularly. The data measuring structure, process, and outcome should be collected systematically and presented in a comparative manner in relation to the facilities.Opportunities for clinical risk management arise from the World Health Organization's Global Action Safety Plan, advances in digitization, the integration of clinical risk management into organizational risk management, and the improvement of structural quality. Clinical risk management must be given even more space in the daily routine of doctors and nurses. This requires competence and human resources in this area. These are not sufficiently available in German hospitals.

摘要

临床风险管理支持医护人员识别、降低和管理患者护理中的风险。在德国医疗体系中,这对所有门诊和住院机构来说都是强制性的。临床风险管理的内容在社会法典(第5编)、联邦联合委员会的指南、患者权利法案以及患者安全联盟的规范和建议中都有规定。联邦联合委员会明确指出,必须实施风险管理、差错管理、差错报告系统、医院投诉管理以及手术干预检查表使用的最低标准。立法者要求定期检查临床风险管理的有效性。德国关于临床风险管理的问卷调查显示总体呈积极发展态势。然而,这些数据不足以进行全面评估。因此,应制定方法可靠的程序,更频繁、定期地检查临床风险管理的状况。应系统收集衡量结构、过程和结果的数据,并以设施对比的方式呈现。临床风险管理的机遇源于世界卫生组织的全球患者安全行动计划、数字化进展、将临床风险管理融入组织风险管理以及结构质量的改善。在医生和护士的日常工作中,临床风险管理必须获得更多空间。这需要该领域的专业能力和人力资源。而德国医院在这方面的资源并不充足。

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