Research On The Monitoring System Of Medical Safety In Shanghai

BackgroundsThe medical safety is facing a severe challenge so how to improve the medical safety is one prerequisite problem should be tackled with.The abroad research indicated that the report basing on voluntary is one effective way to enhance the medical safety which acts as a supplementary way to compulsive report.After does research on the theory and take action from the reality of Shanghai three management net on medical safety,our research team explores and builds the monitoring system of medical safety to improve the medical safety and constitute a harmonious environment for patient and medial staff.ObjectivesUnder the guideline of the "patient-centered" and "safety management",the research establishes a monitoring system of medical safety through the two levels of theory and reality,using the qualitative and quantitative methods,and considering the medical safety management trends of the international and domestic,and combining with the Shanghai social,economic,culture,health and safety management status of the patients.The specific research goals are:â‘ Clarify the definitions and meanings of medical safety and the related concepts;â‘¡Explore the scope,methods and built the indicators of Shanghai medical safety information collection system;â‘¢Explore the methods and contents of Shanghai medical safety information analysis system;â‘£Lay the foundation for the establishment and exploration of the Shanghai medical safety control system(early warning,feedback and evaluation system),then build a comprehensive medical safety monitoring and control system in Shanghai.MethodsThe data of theoretical research,information-gathering system research and analysis system are mainly gathered from literature Review and Charente.The data of Empirical Study are come from the Shanghai medical safety information-gathering system which collected the medical dispute information from April 2007 to March 2008 with eleven pilot units reporting by database of INFOPATH and EPIDATA,and the total number of the medical dispute is 2124.Then gives statistical description of the information in order to understand the basic situation of medical adverse events in Shanghai;simulates the quality control chart on the baseline data of the past year,and explores the method of failure mode effect and criticality analysis so as to provide ideas and methods for the latter control system building.Results1.The modern medical safety theory insists that the medical safety is not limited to patient's safety,should also be concerned on the doctors,hospitals and social security.The monitoring system of medical safety in Shanghai is a broad medical safety monitoring system,so their concerns should not only be focused on the traditional medical adverse events,such as defects in the operation,anesthesia and drug abuse but also on adverse events which has non-direct connect with medical quality,such as patient falls,the attitude of medical staff,the defects of inform and so on.2.The collecting of medical complaints is an effective way to monitor the medical adverse events after analysis the medical theory and the reality in Shanghai medical safety management.The health industry is regarded as a service industry,so the credendum of "customer first" is also its main characteristic.The information, coming from the patient,has a higher value which can evaluate the medical quality.3.Through information-gathering system construction,we set up series of indicators which are composed of two parts:the first part is basic information indicators which are constituted of basic information of patient,basic information of complaints,involving personnel and the current status of patients.The second part is the construction of indicators which contain the reasons of the complaints and the analysis reasons of the medical staff.The reasons of the complaints are composed of the problems of service attitude,management quality,treatment effectiveness,and treatment costs and so on.The analysis reasons of the medical staff are composed of the problems medical defects and non-medical defects.Medical defects are including defects in the medical diagnosis,quality,the implementation of the system deficiencies and so on,while non-medical defects are including patients with high expectations,misunderstanding of inform,and other trouble-making.4.Through information analysis system construction,we establish the analysis system which combines the quantitative analysis and qualitative analysis.With regard to the quantitative analysis which has the characteristics of timely and high efficient, varied,dynamic,it contains the conventional statistical analysis and quality control chart making.With regard to the qualitative analysis which has the characteristics of thorough,it based on the experts implement the methodology of FMECA.5.Through the Empirical Analysis of 2124 medical complaints found that:the high occurrence of complaints section office in hospital is followed by surgery, orthopedics,internal medicine,obstetrics and gynecology and emergency department; high places were hospitalization,outpatient and emergency;The reasons of the complaints are followed by clinical issue with 1367(67.74%);quality of management with 337(16.70%);services attitude with 283(14.02%) and cost of treatment with 172(8.52%).The analysis reasons of the medical staff are followed by the defects of treatment with 285(24.89%);patients misunderstanding the seriousness of the disease with 202(17.64%);complications from surgery with182(15.90%);patients misunderstanding inform with 181(15.81%).