基于失效模式与效应分析的门急诊患者突发事件应急管理的流程优化实践

Process optimization of emergency management for outpatient and emergency patients based on failure mode and effect analysis

目的探讨失效模式与效应分析(failure modes and effects analysis,FMEA)在综合医院门急诊患者突发事件应急管理中的应用效果,为优化门急诊患者突发事件的应急流程提供参考。方法基于FMEA对综合医院门急诊患者突发事件应急流程中的风险进行识别及评估,分析潜在的失效模式,查找出风险优先指数(risk priority number,RPN)>125的重点风险,采取持续质量改进措施进行控制,并对控制效果进行评价,采取χ^(2)检验进行统计分析。结果共发现4大方面16个风险点,通过实施持续质量改进措施,高风险点的RPN均下降至125以下,风险得到有效控制,门急诊急救设备利用率、患者突发事件及时通报率、患者突发事件及时反馈率、患者突发事件急救成功率均明显提升,差异具有统计学意义(P<0.01)。结论将FMEA应用于门急诊患者突发事件应急管理,有利于优化门急诊患者突发事件的应急流程,从而提升综合医院门急诊应急处置能力,使门急诊患者突发事件得到妥善处理。

Objective To explore the effectiveness of Failure Modes and Effects Analysis(FMEA)in emergency management of sudden incidents involving outpatient and emergency patients in general hospitals,to provide references for the optimization of emergency response process for such incidents.Methods Based on FMEA,we identified and evaluated risks in the emergency response procedures for sudden incidents involving outpatient and emergency patients in general hospitals.Potential failure modes were analyzed to identify key risks with a Risk Priority Number(RPN)greater than 125.Continuous quality improvement measures were implemented to control these risks,and the effectiveness of these controls was evaluated using chi-square tests for statistical analysis.Results A total of 16 risk points in 4 major areas were identified.After implementing continuous quality improvement measures,the RPNs of these high-risk points decreased to below 125,effectively controlling the potential risks.This intervention significantly improved the utilization rate of emergency equipment,the timely reporting rate of sudden incidents,the timely feedback rate of emergency response,with statistically significant differences(P<0.01).Conclusion The application of FMEA to outpatient and emergency management of sudden incidents helps optimize the emergency response process,thus enhancing the emergency response capability of general hospitals and ensuring effective handling of such incidents.