安全环节作为医疗保健过程中不断提高质量和安全的战略
Julio J Lopez-Picazo1,2, Inmaculada Vidal-Abarca2, Juana M Marín-Martínez1,2
1Faculty of medicine, Murcia University, Spain.
概括
安全环节 (SRs) 改善了医疗保健质量和安全文化,特别是沟通和领导力支持. 然而,一些安全感知领域下降,需要持续改进战略,以获得更好的患者安全结果.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 提高质量 提高质量
背景情况:
- 安全环节 (SRs) 灵感来自LEAN Gemba访问,以吸引患者安全领域的领导者.
- 特别报告显示了改善安全文化和临床实践的潜力,但有效性各不相同.
- 关于SRs的影响和最佳实施的证据存在碎片.
研究的目的:
- 设计,实施和评估使用SRs以提高医疗保健质量和安全的战略.
- 为了解SR在各种医疗保健环境中的适应做出贡献.
- 评估SRs对患者安全文化和事件报告的影响.
主要方法:
- 在西班牙综合医疗保健领域进行为期五年的准实验性前后研究 (2018-2023年).
- 在五个护理环境 (初级保健,门诊,急诊,住院,手术) 中,多学科的SR设计和部署.
- 通过41个SRS评估122个指标,使用医院患者安全文化调查 (HSOPS) 和事件报告.
主要成果:
- 进行了41个SR,对122个评估指标的平均遵守率为71%.
- 从2017年到2023年,患者安全事件报告增加了27%.
- 在"管理支持患者安全"和"反和沟通"方面有显著的改善;在"安全感知"方面有所下降.
结论:
- 系统设计的SR可以提高患者安全文化和医疗保健质量,特别是沟通和领导力.
- 观察到某些安全维度的下降凸显了SR策略的持续改进的需要.
- 需要进一步的研究来优化SR在各种医疗保健环境中的影响.
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