University Hospitals Sussex, Brighton, UK
University Hospitals Sussex, Brighton, UK.
Clin Med (Lond). 2023 Sep;23(5):508-511. doi: 10.7861/clinmed.2023-0161.
Deaths in hospital represent a vital learning opportunity for both individual clinicians and the wider healthcare system. Many deaths are reviewed and discussed in morbidity and mortality meetings, with the Royal College of Physicians promoting Structured Judgement Review (SJR) methodology to support this discussion. An analysis of 1 year of SJRs in one hospital was undertaken, generating a toolkit to support junior doctors in evaluating in-hospital deaths. Here, the opportunities and limitations of this analysis are discussed, with consideration of ways to improve the uptake of SJR across the hospital team. These reviews exemplify one way of maximising learning from in-hospital deaths.
医院死亡代表着个体临床医生和更广泛的医疗保健系统的重要学习机会。许多死亡案例会在发病率和死亡率会议上进行审查和讨论,皇家内科医师学会(Royal College of Physicians)也提倡使用结构化判断审查(Structured Judgement Review,SJR)方法来支持这种讨论。本文对一家医院的 1 年 SJR 进行了分析,生成了一个工具包,以支持初级医生评估院内死亡病例。本文讨论了这种分析的机会和局限性,并考虑了提高医院团队中 SJR 接受程度的方法。这些审查体现了从医院死亡病例中最大程度地学习的一种方法。