基于失效模式与效应分析的门急诊患者突发事件应急管理的流程优化实践  

Process optimization of emergency management for outpatient and emergency patients based on failure mode and effect analysis

作　　者：吴子怡 谢欣照 王可欣 吕昕怡 周昊阳 陈彦 WU Ziyi;XIE Xinzhao;WANG Kexin;Lv Xinyi;ZHOU Haoyang;CHEN Yan(School of Health Policy&Management,Nanjing Medical University,Nanjing 211166,China;The First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China;Gusu School Nanjing Medical University,Nanjing 215000,China;Suzhou Municipal Hospital,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215002,China;Jiangsu Provincial Institute of Health,Nanjing 211166,China)

机构地区：[1]南京医科大学医政学院,江苏南京211166 [2]南京医科大学第一附属医院,江苏南京210029 [3]南京医科大学姑苏学院,江苏南京215000 [4]苏州市立医院//南京医科大学附属苏州医院,江苏苏州215002 [5]江苏省健康研究院,江苏南京211166

出　　处：《现代医院》2024年第8期1190-1193,1197,共5页Modern Hospitals

基　　金：江苏省医院协会医院管理创新研究重点课题(JSYGY-3-2023-384);江苏省研究生科研创新计划项目(KYCX23_1902);健康江苏研究院2022年度决策咨询培育课题(JX102C20160020);2021年研究生优质教育资源建设项目(2021B016)。

摘　　要：目的探讨失效模式与效应分析(failure modes and effects analysis,FMEA)在综合医院门急诊患者突发事件应急管理中的应用效果,为优化门急诊患者突发事件的应急流程提供参考。方法基于FMEA对综合医院门急诊患者突发事件应急流程中的风险进行识别及评估,分析潜在的失效模式,查找出风险优先指数(risk priority number,RPN)>125的重点风险,采取持续质量改进措施进行控制,并对控制效果进行评价,采取χ^(2)检验进行统计分析。结果共发现4大方面16个风险点,通过实施持续质量改进措施,高风险点的RPN均下降至125以下,风险得到有效控制,门急诊急救设备利用率、患者突发事件及时通报率、患者突发事件及时反馈率、患者突发事件急救成功率均明显提升,差异具有统计学意义(P<0.01)。结论将FMEA应用于门急诊患者突发事件应急管理,有利于优化门急诊患者突发事件的应急流程,从而提升综合医院门急诊应急处置能力,使门急诊患者突发事件得到妥善处理。Objective To explore the effectiveness of Failure Modes and Effects Analysis(FMEA)in emergency management of sudden incidents involving outpatient and emergency patients in general hospitals,to provide references for the optimization of emergency response process for such incidents.Methods Based on FMEA,we identified and evaluated risks in the emergency response procedures for sudden incidents involving outpatient and emergency patients in general hospitals.Potential failure modes were analyzed to identify key risks with a Risk Priority Number(RPN)greater than 125.Continuous quality improvement measures were implemented to control these risks,and the effectiveness of these controls was evaluated using chi-square tests for statistical analysis.Results A total of 16 risk points in 4 major areas were identified.After implementing continuous quality improvement measures,the RPNs of these high-risk points decreased to below 125,effectively controlling the potential risks.This intervention significantly improved the utilization rate of emergency equipment,the timely reporting rate of sudden incidents,the timely feedback rate of emergency response,with statistically significant differences(P<0.01).Conclusion The application of FMEA to outpatient and emergency management of sudden incidents helps optimize the emergency response process,thus enhancing the emergency response capability of general hospitals and ensuring effective handling of such incidents.

关 键 词：失效模式与效应分析 门急诊 突发事件 应急管理 

分 类 号：R197.323.4[医药卫生—卫生事业管理]