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医疗失效模式与效应分析结合服务蓝图——减轻急诊单位大量伤患分类:一项定性研究。

Healthcare failure mode and effect analysis combined service blueprint - Mitigating mass casualty triage in emergency units: A qualitative study.

机构信息

Ph.D. Program of Management, Chung Hua University, Hsinchu 30012, Taiwan, ROC.

Department of Business Administration, Chung Hua University, Hsinchu 30012, Taiwan, ROC.

出版信息

Int Emerg Nurs. 2024 Dec;77:101508. doi: 10.1016/j.ienj.2024.101508. Epub 2024 Sep 4.

DOI:10.1016/j.ienj.2024.101508
PMID:39236663
Abstract

INTRODUCTION

The 24-hour operation of medical emergency units involves crucial first-hand information and medical treatments, which could involve potential complications and disputes if not handled with the utmost professionalism. Effective logistical support and timely activation are crucial in mass casualty triage to prevent systematic treatment issues and chaos.

OBJECTIVE

This study explores the integration of Healthcare Failure Mode and Effect Analysis (HFMEA) with a service blueprint to mitigate medical risks and enhance mass casualty triage efficiency in emergency units.

METHOD

An expert team analyzed emergency unit standard operating procedure cases using a service blueprint to visually represent mass casualty triage scenarios. The HFMEA identified potential hazards and failure risks in healthcare service delivery during mass casualty triage.

RESULTS

Fifteen high-risk hazard indexes exceeding the standard score of eight were identified among three main processes and thirty-one potential failure reasons. The initial operational time for mass casualty triage was approximately 104 min, significantly reduced to 34 min after process revision (p = 0.043, <0.05).

CONCLUSIONS

This study demonstrates effective time management in mass casualty triage, potentially saving up to an hour. Improved operational efficiency allows for focused resuscitation efforts, alleviating concerns about timely patient flow initiation.

摘要

简介

医疗急救单位 24 小时运作,涉及关键的第一手信息和医疗处理,如果处理不当,可能会涉及潜在的并发症和争议。在大规模伤亡分诊中,有效的后勤支持和及时的启动对于防止系统治疗问题和混乱至关重要。

目的

本研究探讨了医疗失效模式与效应分析(HFMEA)与服务蓝图的整合,以减轻医疗风险并提高急救单位的大规模伤亡分诊效率。

方法

一个专家团队使用服务蓝图分析了急救单位的标准操作程序案例,以直观地表示大规模伤亡分诊场景。HFMEA 确定了大规模伤亡分诊过程中医疗服务提供过程中的潜在危害和失效风险。

结果

在三个主要流程中发现了十五个高于标准得分 8 的高风险危害指标,以及三十一个潜在的失效原因。大规模伤亡分诊的初始操作时间约为 104 分钟,经过流程修订后显著缩短至 34 分钟(p=0.043,<0.05)。

结论

本研究表明,大规模伤亡分诊中的时间管理效果显著,潜在节省时间达一小时。操作效率的提高使集中复苏工作成为可能,缓解了对及时启动患者流程的担忧。

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