麻醉品質(zhì)管理之經(jīng)驗~改善患者於手術(shù)室內(nèi)手術(shù)被取消(2009年07月18日).ppt_第1頁
麻醉品質(zhì)管理之經(jīng)驗~改善患者於手術(shù)室內(nèi)手術(shù)被取消(2009年07月18日).ppt_第2頁
麻醉品質(zhì)管理之經(jīng)驗~改善患者於手術(shù)室內(nèi)手術(shù)被取消(2009年07月18日).ppt_第3頁
麻醉品質(zhì)管理之經(jīng)驗~改善患者於手術(shù)室內(nèi)手術(shù)被取消(2009年07月18日).ppt_第4頁
麻醉品質(zhì)管理之經(jīng)驗~改善患者於手術(shù)室內(nèi)手術(shù)被取消(2009年07月18日).ppt_第5頁
已閱讀5頁,還剩14頁未讀 繼續(xù)免費閱讀

下載本文檔

版權(quán)說明:本文檔由用戶提供并上傳,收益歸屬內(nèi)容提供方,若內(nèi)容存在侵權(quán),請進(jìn)行舉報或認(rèn)領(lǐng)

文檔簡介

2019/9/17,1,麻醉品質(zhì)管理之經(jīng)驗 改善患者於手術(shù)室內(nèi)手術(shù)被取消 (2009年07月18日),中山醫(yī)學(xué)大學(xué)附設(shè)醫(yī)院麻醉科主治醫(yī)師劉漢傑,2019/9/17,2,2009年臺灣麻醉品質(zhì)與安全研討會,Reports of the Institute of Medicine (IOM),The U.S. health care system performs far below obtainable levels of patient safety and overall customer values. The 1999 IOM report estimated that 44,000 to 98,000 Americans die each year as a result of medical errors. (Effective Clinical Practice, November/December 2000.),2019/9/17,3,2009年臺灣麻醉品質(zhì)與安全研討會,Reports of Harvard University,RAND researchers found that 3% of U.S. inpatients experience avoidable harm and that opportunities for significant improvement in patient functional status are missed in 11% of chronically ill outpatients.,2019/9/17,4,2009年臺灣麻醉品質(zhì)與安全研討會,Total number of cases = 67 (100%) * One young patient showed type II of a second degree atrioventricular block on the EKG monitor in the OT, one young male needed further surgical work up after the anesthesia was given.,2019/9/17,5,2009年臺灣麻醉品質(zhì)與安全研討會,Table 2-Classification of persons who postponed or cancelled the Surgery,Total number of cases = 67 (100%) Board letters indicate the sum of the related items. * The patients family cancelled the surgery because of insurance problems.,2019/9/17,6,2009年臺灣麻醉品質(zhì)與安全研討會,Table 3-Categories of Patients Surgeries Postponed or Cancelled inside the Operating Theater,2019/9/17,7,Table 3a-Categories of Patients Surgeries Postponed or Cancelled inside the Operating Theater,Total number of cases = 67 (100%) Fever (1), change in neurological condition (1), hypoglycemia (1). No fasting (1), the patient or family wanted to cancel the surgery when the patient was in the operating theater (2), insurance problems (2), poor communication between caregivers (2).,2019/9/17,8,2009年臺灣麻醉品質(zhì)與安全研討會,Table 4-Surgical results of Patients after their Surgeries were Postponed or Cancelled,Total number of cases = 67 (100%) . * Surgery was no longer needed (2), cardiovascular accident 2 months later (1), surgery was performed 1 year later (1). * Patient expired after surgery was cancelled: range 1 day-20 days, mean 12.7 days.,2019/9/17,9,2009年臺灣麻醉品質(zhì)與安全研討會,Table 4a -Surgical results of Patients after their Surgeries were Postponed or Cancelled,Total number of cases = 67 (100%) * Surgery was no longer needed (2), cardiovascular accident 2 months later (1), surgery was performed 1 year later (1). * Patient expired after surgery was cancelled: range 1 day-20 days, mean 12.7 days.,2019/9/17,10,2009年臺灣麻醉品質(zhì)與安全研討會,The 5Rs steps to Improve Healthcare Quality in the Hospital of CSMU,2019/9/17,11,2009年臺灣麻醉品質(zhì)與安全研討會,2019/9/17,12,2009年臺灣麻醉品質(zhì)與安全研討會,The Donabedians trilogy,2019/9/17,13,2009年臺灣麻醉品質(zhì)與安全研討會,Review and analysis,Item-by-item. ( Data will be presented by percentage for comparison ). SD, Mean, Mode,2019/9/17,14,2009年臺灣麻醉品質(zhì)與安全研討會,Retrain,Use PDCA cycle (plan, do, check retraining in the monthly meeting, discussion and presentation,2019/9/17,15,Reduce,Preventing the recurrence of similar cases or situations (especially for high incidence group) will reduce the number of unwanted event.,2019/9/17,16,2009年臺灣麻醉品質(zhì)與安全研討會,Proposed Safety Initiatives,1. Computer Physician Order Entry 2. Evidence-Based Hospital Referral 3. Physician Staffing in the ICU ( OR ),2019/9/17,17,

溫馨提示

  • 1. 本站所有資源如無特殊說明,都需要本地電腦安裝OFFICE2007和PDF閱讀器。圖紙軟件為CAD,CAXA,PROE,UG,SolidWorks等.壓縮文件請下載最新的WinRAR軟件解壓。
  • 2. 本站的文檔不包含任何第三方提供的附件圖紙等,如果需要附件,請聯(lián)系上傳者。文件的所有權(quán)益歸上傳用戶所有。
  • 3. 本站RAR壓縮包中若帶圖紙,網(wǎng)頁內(nèi)容里面會有圖紙預(yù)覽,若沒有圖紙預(yù)覽就沒有圖紙。
  • 4. 未經(jīng)權(quán)益所有人同意不得將文件中的內(nèi)容挪作商業(yè)或盈利用途。
  • 5. 人人文庫網(wǎng)僅提供信息存儲空間,僅對用戶上傳內(nèi)容的表現(xiàn)方式做保護處理,對用戶上傳分享的文檔內(nèi)容本身不做任何修改或編輯,并不能對任何下載內(nèi)容負(fù)責(zé)。
  • 6. 下載文件中如有侵權(quán)或不適當(dāng)內(nèi)容,請與我們聯(lián)系,我們立即糾正。
  • 7. 本站不保證下載資源的準(zhǔn)確性、安全性和完整性, 同時也不承擔(dān)用戶因使用這些下載資源對自己和他人造成任何形式的傷害或損失。

評論

0/150

提交評論