医疗失效模式与效应分析在慢性病管理中应用可行性分析

Feasibility analysis of healthcare failure mode and effect analysis in chronic disease management

医疗失效模式与效应分析(healthcare failure mode and effect analysis,HFMEA)是在失效模式与效应分析(failure mode and effects analysis,FMEA)基础上,整合了危害分析与关键控制点(hazard analysis and critical point,HACCP)及根本原因分析法(root cause analysis,RCA)等理论,形成的一种基于团队、系统和前瞻性的可靠性分析方法,通过对医疗服务系统中潜在失效问题的严重程度、发生率等进行评估,辨别存在的安全风险,预先建立预防措施,设计或优化医疗服务流程,以预防不良事件的发生。HFMEA在慢性病管理中应用的可行性,为我国社区慢性病管理质量持续提升提供新的思路。采用文献分析法归纳HFMEA的起源、概念及内涵特征,详细分析HFMEA的实施方法和步骤以及新的发展趋势,并聚焦当前我国社区慢性病管理热点问题,阐明应用HFMEA理论进行慢性病管理的具体可行性。HFMEA是国际先进的前瞻性医疗质量管理方法,在我国社区慢性病管理领域应用具有极其必要性和可行性,有利于将"事后纠正"的规范化管理模式转变为"事前预防"的风险控制机制,从而提高慢性病管理水平。

Health care failure mode and effect analysis(HFMEA)is based on failure mode and effect analysis(FMEA),which integrates hazard analysis and critical point(HACCP)and root cause analysis(RCA).A team-based,systematic and prospective reliability analysis method is proposed to identify the safety risks by assessing the severity and incidence of potential failures in the medical service system,to establish preventive measures in advance,and to design or optimize the medical service process in order to prevent the occurrence of adverse events.The feasibility of applying HFMEA in chronic disease management provides a new way to improve the quality of community chronic disease management in China.This paper sums up the origin,concept and connotation of HFMEA by literature analysis,and analyses the implementation methods and steps of HFMEA and its new development trend in detail,focusing on the current hot issues of community chronic disease management in China,we clarify the specific feasibility of applying HFMEA theory to chronic disease management.HFMEA is an advanced and forward-looking medical quality management method in the world.It is extremely necessary and feasible to apply HFMEA in the field of community chronic disease management in China.It is conducive to transforming the standardized management mode of'post-correction'into the risk control mechanism of'pre-prevention',so as to improve the level of chronic disease management.