ブリストル,シップマン,および臨床ガバナンス:シェワハートの忘れられた教訓
M A Mohammed1, K K Cheng, A Rouse
1Department of Surgery, University of Birmingham, Edgbaston, UK.
Lancet (London, England)
|March 29, 2001
まとめ
ウォルター・シェワハートの制御図は,変動の経済的な制御のための方法であり,一般的な原因と特別な原因を区別する. このアプローチは,品質と臨床ガバナンスを改善するために不可欠であり,6つのケーススタディで示されています.
科学分野:
- 品質管理 品質管理について
- 統計プロセス制御 統計プロセス制御
- 保健医療の改善について
背景:
- 製造業は,過去100年にわたって製品の品質を大幅に改善しました.
- ウォルター・A・シワハートの変異の経済的な制御に関する研究は,この成功に決定的な役割を果たしています.
- Shewhartの制御図は,一般的な原因と特殊な原因の違いを区別するためのグラフィック的な方法を提供します.
研究 の 目的:
- 臨床ガバナンスの達成におけるシェワハートのコントロールチャートアプローチの中心的な役割を実証するため.
- 統計的プロセス制御の実用的な応用を現実世界のシナリオで示すために.
- 変化の理解が,品質と安全性の有形な改善につながる方法を強調する.
主な方法:
- シェワハートのコントロールチャート方法論の適用.
- 6つの異なるケーススタディの分析.
- 変異分類の検討 (一般的な原因と特別な原因).
主要な成果:
- コントロールチャートは,変化の源を特定することによって,適切な改善行動にユーザーを効果的に導きます.
- ブリストルの小児心臓外科手術による過度の死亡,ハロルド・シップマンの行動などの注目事件を含むケーススタディは,この方法の有用性を示しています.
- このアプローチは,臨床ガバナンス (clinical governance) 原則を実用化するのに役立つことが証明されました.
結論:
- シェワハートのコントロールチャート方法論は,ヘルスケアを含む様々な分野における品質改善のための強力なツールです.
- 効果的な問題解決とプロセス強化には,共通原因と特殊原因の違いを区別することが不可欠です.
- 統計的プロセス制御の原則の適用は,堅実な臨床ガバナンスと患者の安全を達成するのに大きく貢献することができます.
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