我国煤矿业风险管理现状的循证评价——医疗风险系列研究之二

Evidence-Based Evaluation of Coal-mining Risk Management in China

目的循证评价我国煤矿业风险及管理现状,为同属高风险行业的医疗行业风险控制提供参考。方法计算机检索EI(1969-2005)、SDOS(1995-2005)、维普全文数据(1989-2005)、万方数据库(会议论文:1997-2005;学位论文: 1977-2005)、CNKI数据库(1994-2005)、MSHA(msha．gov)及相关官方网站。收集我国矿业安全现状、应急救援、风险管理及预警的文献。语种限制为英文和中文。结果共纳入19篇文献,其中官方文献9篇,研究性文献4篇．专家评论6 篇。近年我国煤矿业安全状况有所改善,矿难呈下降趋势,但远较美国高。占全国煤矿90％的小煤矿安全问题突出。我国煤矿业应急救援及预警体系还不完善。结论我国医疗行业应吸取我国矿难频发的教训．积极关注占我国医疗机构 68．24％的诊所的医疗服务质量,对各级医务人员开展多层面、多形式、多内容培训,提高其风险防范意识和法律意识．并建立员工主动上报小差错制度。

Objective To provide reference for medical risk management by evidence-based evaluation of the status of coal-mining risk management in China. Methods We searched databases of EI （1969 to 2005）, SDOS （1995 to 2005）, Vip （1989 to 2005）, Wanfang （up to 2005）, and CNKI （1994 to 2005）, as well as some official websites, for English and Chinese articles related to coal-mining safety, risk management, precaution, and response to mine disasters in China. Results Total of 19 articles, including 9 official documents, 4 research articles, and 6 expert comments were included. Recently the number of coal-mining disasters has declined in China, but still much larger than that in US. The safety status of small coal mines （90% of total coal mines in China） was much more severe. The response and precaution system of coal mining disaster in China was poor. Conclusion Medical service in China may take the following measures based on lessons from coal mining industry to improve its risk management： ① Strengthen the management of small clinics （68.24% of total medical organizations in China）; ②Train doctors and nurses to upgrade their perception of medical risk; ③ Establish self-report system of medical malpractices, errors, and accidents.