The Study On Process Reengineering Of Critical Patients Transfer Based On Safety Culture

Business Process Reengineering(BPR) is a new management theoryand method which originated from America in1990s and then spreadaround the word rapidly, it’s used in many domains. In order to enhance thecore competitiveness and strengthen the hospital management, manyhospitals introduced the BPR to reengineer various processes.Along with the public’s requirements and quality of the medicalservices are increasing in recent years, their self-protection awareness areenhancing, security of patients is becoming the highest priority work inhospitals. Development of safety culture is a potential strategy to improvepatients’ safety. Positive safety culture accepts the error events, and takes theinitiative to look for problems in system and improves the procedures. Thereis a serious risk existing in the transfer process of critical patients.And anon-standard transfer process could result in accidents or deaths, whichaffected the doctor-patient relationship, and also leaded a lawsuit. So it has astrongly requirement for a reengineering the transfer process for criticalpatients using BRP theory,avoiding transfer accidents systematically, making benefits for reduce medical accidents, establishing a positive safetyculture environment.Objective: To define the existing transfer process of critical patientsand find out the problems. On this basis, designing a new transfer process inorder to reduce system error and construct a positive safety cultureenvironment.Methods:1. Document Search: Searched the related documents of transferprocess for critical patients, extracted the nodes of transfer process anddesigned the questionnaire for survey the transfer process.2.Field Research Method: Researched the transfer process in the hos-pital to find out the problems existing in the process. Researched thereengineering process and evaluated the effect.3.Delphi method: Consulted experts in the hospital to ensure the newtransfer process are scientific and reasonable.Results:1. Analyzed74documents, picked up9key nodes,27detail nodes anddefined the connotation of the nodes according to the time line of the transferprocess.2. Designed the questionnaire for survey the transfer process, includingbasic information, communication, transfer preparation, transfer process,arrived destination ward, return ward (applicable to patients who examine outward) and time points.3. found out the problems existing in the transfer process.The Systemproblems of the hospital management department including the system andprocess for critical patients transfer are imperfect, no systematic training forstaffs; the problems of the process including destination ward and surgeryelevator not informed, items prepare insufficiency, patient safety had notbeen paid enough attention,transfer staff had no qualification, the real-timerecord disease had not noted,transfer division unclear, medical staffstanding the incorrect place, destination department prepare insufficiency,handover work unclear.4. Reengineered the transfer process of emergency department todestination ward, general wards to ICU, outward examination for criticalpatients and write the instructions for key nodes in the new process.5. The accident probability reduced after reengineering, the behavioralnormative for medical staff’s were obvious improvement on informingdestination departments, transport division of work, standing positions,transfer handover after reengineering, there were no significant differenceon informing surgery elevator, items preparing, constraining the restlesspatients, transport staff’s qualification, preparing of destination ward,handover work. Medical staffs were satisfied with the new process.Conclusions:1. The hospital process reengineering need the direction of BPR theory, and follow the scientific methods and steps.2. The transfer process for critical patients in this study are scientific,reasonable and operable, it can regularize the behavior of medical staff andreduce transfer accidents.3. The reengineering work based on safety culture enhance the safetyculture enviroment of the hospital. Medical institutions should pay attentionto the construction of hospital safety culture.