失效模式与效应分析在优化患者亲属标本管理中的应用  

Application of failure mode and effect analysis in optimizing the management of specimens from relatives of patients

作　　者：刘昊 徐家骅[1] 张海莹[1] 王密诗 黄国英[3] LIU Hao;XU Jiahua;ZHANG Haiying;WANG Mishi;HUANG Guoying(Quality Control Department,Children’s Hospital of Fudan University,Shanghai 201102,P.R.China;Operation Management Department,Children’s Hospital of Fudan University,Shanghai 201102,P.R.China;Hospital Office,Children’s Hospital of Fudan University,Shanghai 201102,P.R.China)

机构地区：[1]复旦大学附属儿科医院质量控制办公室,上海201102 [2]复旦大学附属儿科医院运营管理部,上海201102 [3]复旦大学附属儿科医院院长办公室,上海201102

出　　处：《华西医学》2022年第11期1697-1700,共4页West China Medical Journal

基　　金：中国妇幼保健协会妇儿健康临床标准与规范化项目(ZGFY-B-201902)。

摘　　要：目的探讨使用失效模式与效应分析(failure mode and effect analysis,FMEA)优化患者亲属标本管理的流程并分析其效果。方法选取复旦大学附属儿科医院2019年10月—2020年6月全部患者亲属标本的数据资料。将2019年10月—2020年3月患者亲属标本的数据资料作为FMEA项目实施前组(实施前组),2020年4月—6月患者亲属标本的数据资料作为FMEA项目实施后组(实施后组)。使用FMEA法评估患者亲属标本管理流程中存在的风险点,并分析其原因提出改进对策,并比较FMEA实施前后对医院患者亲属标本管理优化的效果。结果共纳入12117例患者亲属标本。其中,实施前组6132例,实施后组5985例。共发现潜在失效模式13项,其中高风险3项、中风险3项、低风险7项。FMEA项目实施后,3项高风险失效模式、1项中风险失效模式“检验类型申请错误”及1项低风险失效模式“诊断错误”的风险程度均低于实施前(P<0.05)。访谈结果显示,FMEA项目实施后提高了相关医务人员工作满意度与风险意识。结论在使用FMEA优化患者亲属标本管理流程中准确抓取风险点,可降低流程潜在风险,预防可能发生的差错,提高工作效率与工作满意度,为医院管理者提供借鉴。Objective To explore the process of using failure mode and effect analysis(FMEA)to optimize the management of specimens from relatives of patients and analyze its effects.Methods The data of the specimens tested by the family members of hospital patients between October 2019 and June 2020 in the Children’s Hospital of Fudan University were collected.The data between October 2019 and March 2020 were taken as the pre-FMEA group,and the data between April 2020 and June 2020 were taken as the FMEA group.We used FMEA method to evaluate the risk points in the management of specimens from relatives of patients,analyzed the reasons to propose improvement measures,and compared the effect of optimizing the management of specimens from relatives of patients before and after the implementation of FMEA.Results A total of 12117 specimens from relatives of patients were included,including 6132 cases in the pre-FMEA group and 5985 cases in the FMEA group.A total of 13 potential failure modes were found,including 3 high risk,3 medium risk and 7 low risk.After the implementation of FMEA,the 3 high risk failure modes,1 medium risk failure modes“inspection type application error”and 1 low risk failure modes“diagnosis error”were lower than that pre-FMEA(P<0.05).The interview results showed that the job satisfaction and work risk awareness of relevant medical staff were improved after the implementation of FMEA.Conclusions The use of FMEA to optimize the management process of patient family specimens accurately captures the risk points.After the implementation of the improvement,the potential risk of the process is reduced,possible errors are prevented,work efficiency and job satisfaction are improved,and it can be used as a reference for hospital managers.

关 键 词：失效模式与效应分析 患者亲属标本 标本管理 流程优化 

分 类 号：R197.32[医药卫生—卫生事业管理]