Three Kinds of Proactive Risk Analyses for Health Care

Garill Coles; Becky Fuller; Kathleen Nordquist; Steve Weissenberger; Leann Anderson; Brooke DuBois

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Three Kinds of Proactive Risk Analyses for Health Care

机译：卫生保健的三种前瞻性风险分析

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Background: In health care, proactive risk assessment usually takes the form of Failure Mode and Effects Analysis (FMEA). An applied research firm, four community hospitals, and a community health care alliance in south-central Washington State-as members of the Tri-Cities Patient Safety Coalition (TCPSC)-used proactive risk assessment methods such as event tree analysis (ETA) and hazard identification to assess the risk of adverse events associated with a process or system.rnCase Studies: (1) ETA of a Mental Health Issue: An assessment was performed to understand the risk presented by emergency department (ED) patients with underlying mental health or substance abuse issues. The study led hospital management to provide training in crisis prevention for staff who might be confronted with similar scenarios. (2) Hazard Identification of Patient-Owned Equipment: Following a postsurgery incident involving patient-owned equipment, equipment brought into the hospital was assessed using a hazard identification checklist. The results led one hospital to bar equipment determined to represent unacceptable potential patient harm. (3) FMEA of Inter-hospital Patient Transfer: Hospital patients often must be transferred to another community hospital for services (such as diagnostic imaging) and then returned-entailing many handoffs and associated patient safety issues. The FMEA and accompanying process map helped the hospitals design a form that includes patient safety-related information and that requires staff to check the patient's status. Conclusions: The south-central Washington group has learned that other kinds of proactive risk assessment beyond FMEA that are commonly used by engineers can be used to assess the specific kinds of high-risk processes found in health care.

机译：背景：在医疗保健中，主动风险评估通常采用故障模式和影响分析（FMEA）的形式。一家应用研究公司，四家社区医院和位于华盛顿州中南部的社区医疗保健联盟（作为三城市患者安全联盟（TCPSC）的成员）使用了主动风险评估方法，例如事件树分析（ETA）和案例研究：（1）精神健康问题的预计到达时间：进行了一项评估，以了解急诊科（ED）患者具有潜在精神健康状况或药物滥用问题。该研究使医院管理层为可能面临类似情况的工作人员提供了预防危机的培训。（2）患者自备设备的危害识别：涉及患者自备设备的手术后事件发生后，使用危害识别检查表对带入医院的设备进行了评估。结果导致一家医院禁止使用被确定为代表无法接受的潜在患者伤害的设备。（3）医院间患者转移的FMEA：通常必须将医院患者转移到另一社区医院接受服务（例如诊断成像），然后再返回，这会带来许多移交和相关的患者安全问题。 FMEA和随附的流程图帮助医院设计了一个表格，其中包括与患者安全相关的信息，并且要求工作人员检查患者的状况。结论：中南部华盛顿小组了解到，工程师通常使用的FMEA以外的其他类型的主动风险评估可用于评估医疗保健中发现的特定种类的高风险过程。

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《The joint commission journal on quality and patient safety》 |2010年第8期|P.365-375|共11页
作者
Garill Coles; Becky Fuller; Kathleen Nordquist; Steve Weissenberger; Leann Anderson; Brooke DuBois;
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Battelle, Pacific Northwest Division, Richland, Washington;

rnKadlec Regional Medical Center, Richland, Washington;

rnKennewick General Hospital, Kennewick, Washingto Mirasol Family Health Center, Hermiston, Oregon;

rnLourdes Health Network, Pasco, Washington;

rnPatient Care Services;

rnBenton-Franklin Community Health Alliance, Kennewick, Washington;

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机译：医疗保健工人可以合理地质疑护理责任，而医疗保健机构采取反应（而不是主动）对传染病风险的影响？
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机译：埃博拉感染患者的积极风险评估：一种系统的方法，可以识别和最小化对医疗保健人员的风险
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4. Proactive Risk Assessment of Team Health IT for Pediatric Trauma Care Transitions (T~3) [C] . Peter L. T. Hoonakker, Pascale Carayon, Bat-Zion Hose, International Conference on Healthcare Ergonomics and Patient Safety . 2019

机译：用于儿科创伤过渡的团队健康的主动风险评估（T〜3）
5. Evaluation of the relationship between proactive risk assessment and episodes of challenging behavior in community-based behavioral health care settings. [D] . Reese, Cindy. 2009

机译：在基于社区的行为医疗机构中，对主动风险评估与挑战性行为发作之间的关系进行评估。
6. 1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent CVA Catheter Replacement Within 7 days and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors for CAUTI and Intend to Utilize These to Deploy a Tiered Approach Where Patients with Risk Factors Will Receive Advanced in Addition to Basic Preventive Efforts [O] . Neha Nanda, Meline Aleksanyan -1

机译：1160. CAUTI是医疗保健相关感染的最常见类型。为了通过主动预防来降低CAUTI率我们试图建立一个加权的CAUTI危险因素模型。最终共同预测CAUTI的最终风险因素是ADL依赖CVA7天内更换导管且导管插入持续时间≥5。我们已经为CAUTI定义了当代加权风险因素并打算利用这些风险因素来部署一种分级方法使具有风险因素的患者除了基本的预防措施外还将获得先进的治疗
7. Renal insufficiency and anemia are independent risk factors for death among patients with acute myocardial infarction1,21As published material, the contents of this manuscript may not be cited, quoted, reproduced or published without the consent of the authors.2The analyses upon which this publication is based were performed under Contract Number 500-96-P704, entitled “Operation Utilization and Quality Control Peer Review Organization (PRO) for the State of Georgia” and sponsored by the Centers for Medicare and Medicaid Services (CMS), Department of Health and Human Services. The conclusions and opinions expressed, and methods used herein are those of the authors. They do not necessarily reflect CMS policy. The authors assume full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by CMS, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore required no special funding on the part of this Contractor. Ideas and contributions to the authors concerning experience in engaging with issues presented are welcomed. [O] . Langston Robert D., Presley Rodney, Flanders W. Dana, 2003

机译：肾功能不全和贫血是急性心肌梗死患者死亡的独立危险因素1,21作为已发表的材料，未经作者的同意，不得引用，引用，复制或出版该手稿的内容。2本出版物所依据的分析这些工作是根据合同号500-96-P704进行的，该合同的标题为“佐治亚州的运营利用和质量控制同行评审组织（PRO）”，由卫生与人文部医疗保险和医疗补助中心（CMS）赞助服务。所表达的结论和意见以及本文使用的方法均为作者的结论和意见。它们不一定反映CMS政策。作者对所提出想法的准确性和完整性承担全部责任。本文是CMS发起的“医疗保健质量改善计划”的直接结果，该计划鼓励鉴定通过对护理模式进行分析而得出的质量改善项目，因此该承包商不需要任何特殊资金。欢迎作者提出解决问题的经验和想法。

Three Kinds of Proactive Risk Analyses for Health Care

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