Research On The Early Warning System Of Medical Safety

BackgroundsAs we accept the patient centered idea of the medical safety management, how to improve the quality of medical service, drop the medical risk in the course of treatment and safeguard the patient safety has became the social focus. But because of the particularity of healthcare practitioner and technical occupations, many kinds of the medical safety adverse events which influence patient, medical department and society heavily often happened. The traditional passive treatment measures "emergency and handle" just cure the symptoms, not the disease--temporary medical relief effect. Therefore, many scholars at home and aboard begin to explore new medical safety management model. By documentary analysis and expert demonstration, the research group of shanghai medical safety monitoring and controlling system initiatory built the frame of medical safety monitoring and controlling system. This reaserch analyse the neccesity and feasibility of building medical safety early warning system and think that it will be an important measure to prevent and control medical safety adverse events.ObjectivesMedical safety early warning system is to find the unusual phenomenon of medical treatment and take precautions against adverse events, this paper focuses on the research of current situation of medical safety adverse events monitoring and controlling system, acquaintaning the relative concepts, composition and function and fundamental theory of medical safety early warning system. According to the target location of medical safety early warning system-"improve medical quality, decrease of the doctor-patient dispute, build harmonious doctor-patient environment and promote patient safety" and reference to our medical department management and running addition, we work out our own medical safety early warning system model. To build medical safety early warning system to provide early warning of adverse events of medical system, and set up strategic pass forward and prevention first medical dispute and medical negligence emergency management strategy.MethodsTo summarize the status of medical safety management at home and abroad through literature collation and analysis; to proof and evaluate the relative theory of medical safety early warning system by interviewing key person in the know and expert demonstration; using the model of " Shewhart quality control chart" to pre-alarm the quantity or incidence rate of medical safety adverse events; to build medical safety integrated density of infection by analytic hierarchy process and comprehensive evaluation method; to implore the root of medical safety adverse events by the Fishbone Diagram and RCA analytical method; to resume the emergency management strategy of medical safety adverse events based on summarizing; upper empirical research materials comes from the 72 pilot units by INFOPATH data based of the shanghai medical safety information collection system from 2008.04 to 2009.12.Results1. To clear off the conception relative to medical safety early warning and their relationship from the theory angle. Medical safety, medical quality and medical risk is closely connection, improving medical quality is a tool, avoiding medical risk is a bridge, pursuing medical safety is target. Monitoring is the base of forecast and early warning, early warning not only contain forecast, but also emphasize the Information processing, so it is higher level forecast.2. To explicit the conception, essential characteristic, essential function and basic principles of medical safety early warning system. In this paper, the system contains four parts which are analysis system, decision making system, Warning systems and emergency system. It has two early warning dimensionalities. One is the quantity or incidence rate of medical safety adverse events, another is harmful effect of medical safety adverse events. Different dimensionality had different early warning grade and distinct colour.3. Using the " Shewhart quality control chart" model to pre-alarm the quantity or incidence rate of medical safety adverse events. In this research, we need to compute the quantity or incidence rate of medical safety adverse events reported in a month, and then we determine which stage it is according to it's deviation value. 4. In this research, we choose patient harm index, medical institution effects index and society effects index as our index of routine analysis,first we need to compute the score of the three index, and then we sum respectively the medical safety adverse events reported in a day. We can compute the integrated density of infection of every medical safety adverse event by comprehensive evaluation method. At the same time, we can also compute the total score of all medical safety adverse events reported in a day.5. Use RCA analytical tool-Cause and Effect Diagrams to build analysis model of medical safety adverse events, to analyse the root of medical safety adverse events, make use of these information to lay down pertinency strategy, by doing this, it can medical safety quality and safeguard the patient medical safety.6. Early warning message is released by authority organization, information receiver should know use what emergency management measures according to the urgent degree of early warning information. In order to ensure the the efficiency of working, we lay down emergency management operational scheme. Different early warning stage has different emergency management measures, in this research, we establish two kinds of emergency management strategy from two early warning dimensionalities.7. From the empirical analysis, we find that the quantity of medical safety adverse events reported reached red early warning and yellow early warning three times respectively. The incidence rate inappropriate surgical operation of medical safety adverse events reported reached yellow early warning four times. The case shows that the early warning of medical safety dangerous consequence is a dynamic process, at the same time, to find the deep reason of adverse events can reach the effect of improving medical quality and preventing medical risk.