某三级公立医院不良事件管理现状及对策

Current Situation and Countermeasures of Adverse Event Management in a Tertiary Public Hospital

目的优化院内不良事件报告制度及处理流程,最大限度减少患者损害,不断提高医院管理效率和效能。方法采用定量分析(回顾性分析2019年1月—2021年12月不良事件上报情况)和定性研究(问卷调查、现场访谈)相结合方式,了解无锡市第九医院不良事件管理现状,剖析当前运行中存在问题。结果医技、行政人员对不良事件的内容及分级概念模糊,掌握程度不足60%;每百名出院人次上报例数≥2.93,每百张床位年报告例数≥99.18,上报例数较高且逐年递增;存在上报途径重复多样,上报内容不全,有缺项漏项;职能部门职责及作用发挥效果不明显等问题。结论明确部门,细化类别,统一管理,确保各职能部门职责清晰;重新梳理审定不良事件报告制度及处理流程,统一表单,优化流程,实现流程价值保值增值;定期开展培训与考核,加强分级管理并纳入科室目标绩效考核,最终本院不良事件有效上报率、质量和内涵均有不同程度提高,职能科室分工明确,协作有效,真正起到了杜绝安全隐患、提升医疗质量、保障患者安全的作用。

Objective To optimize the hospital adverse event reporting system and processing process,minimize the damage of patients,and constantly improve the efficiency and effectiveness of hospital management.Methods A combination of quantitative analysis(retrospective analysis of adverse events reported from January 2019 to December 2021)and qualitative research(questionnaire survey and on-site interview)was adopted,to understand the current situation of adverse event management of Wuxi Ninth People's Hospital and analyze the existing problems in the current operation.Results Medical and administrative personnel had vague concepts about the content and classification of adverse events,and the degree of mastery was less than 60%.The number of reported cases per 100 discharged patients was≥2.93,and the number of reported cases per 100 beds was≥99.18,which was relatively high and increasing year by year.There were multiple reporting channels,incomplete reporting contents,and missing items.There were problems such as the functions and functions of functional departments were not playing an obvious role.Conclusion Clear departments,refine categories,unified management,to ensure that the responsibilities of various functional departments clear;re-sort out the approval of adverse event reporting system and processing procedures,unified form,optimize the process to achieve value preservation and appreciation process;regularly carry out training and assessment,strengthen the classification management and into the department target performance appraisal,finally the effective reporting rate,quality and connotation of adverse events in our hospital have been improved to varying degrees.The division of functional departments is clear,and the cooperation is effective,which really plays a role in preventing safety risks,improving medical quality and ensuring the safety of patients.