JP2002132955A - System for preventing malpractice - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a system for effectively preventing or reducing malpractices by focusing attention on the occurrence possibility of each malpractice. SOLUTION: This malpractice prevention system reduces the occurrence possibility of the malpractices, prevents the occurrence of the malpractice beforehand or aims at reducing the malpractice to nought, by repeating an (A) measure planning process, in which a database formed by defining malpractice contents as a record unit is prepared by identifying the malpractices, having a possibility of taking place according to a medical treatment improvement direction, a measure activity of a malpractice that becomes equal to or greater than a specific rank by ranking occurrence possibility, based on evaluation reference is planned and written additionally in a corresponding record of the database; a (B) measure performance process, in which the measure activity is conducted and the results of the measure activity are added to the corresponding record of the database, while reducing the occurrence possibility of the malpractice that is equal to or greater than the specific rank; a (C) activity evaluation process, in which the measure activity results are evaluated, and a (D) results reflecting process, in which a current medical treatment activity is re-examined regarding the malpractice which is equal to or greater than the specific rank that has undergone the measure activity performance and evaluation.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical malpractice prevention system for preventing or reducing medical malpractice.

[0002]

2. Description of the Related Art In recent years, medical errors have frequently occurred due to complex factors such as complicated medical technology and a relative decrease in the number of skilled medical workers. Needless to say, it is desirable not to cause a medical error. However, in practice, it is difficult to eradicate the medical error because of the factors described above and an act that also involves human intervention. Furthermore,
There are too many situations in which medical errors occur, and different hospitals and medical facilities are now dealing differently, so it is quite difficult to prevent or reduce medical errors. Under these circumstances, no systematic medical malpractice measures have been taken.

[0003]

SUMMARY OF THE INVENTION It is practically impossible to find out the direct cause of medical malpractice and to take complete measures, and it seems that the effect is low for labor.
However, in the medical field, it is possible to feel an action or a system that may cause a medical error. In other words, if systematic measures are taken against the possibility of medical errors, the occurrence of medical errors can be indirectly prevented,
It is thought that it can be reduced. Therefore, prevention or reduction of such medical errors was studied in order to develop a system that effectively takes measures by focusing on the possibility of occurrence of each medical error.

[0004]

[Means for Solving the Problems] According to the medical improvement policy, a medical error that has been developed as a result of the examination is identified, a database in which the contents of the medical error are recorded in units of records is created, and the database is created based on the evaluation criteria. A countermeasure planning process in which a countermeasure for a medical error with a specific rank or higher due to the ranking of the likelihood is planned and added to the corresponding record in the database; While reducing the possibility, the result of this countermeasure activity is added to the corresponding record in the database B. The process of implementing the countermeasure B and the result C of evaluating the result of the countermeasure activity
It consists of an activity evaluation process and a D result reflection process for reviewing the current medical practice for medical errors of a specific rank or higher that have been implemented and evaluated for countermeasure activities. And a medical error prevention system for preventing or reducing the occurrence of the medical error. In the present invention, in order to prevent or reduce the occurrence of medical errors indirectly, rather than directly catching medical errors, the possibility of occurrence is reduced by repeating a four-step process (cycle). Is realized.

[0005] In the A measure planning process, a medical improvement policy is first created (A-1 policy creation process). The medical improvement policy determines the direction of the system cycle. Then, identify medical errors that may occur according to the medical improvement policy,
A database is created with the contents of this medical error in record units (A-2 current status confirmation process). Different medical improvement policies will change the types of medical errors that can be identified in this A-2 current status confirmation process. The database lists medical malpractice objectively and clearly. The database is preferably created on a computer, but may be a document or table on paper or paper. This database manages the preparation, practice, results, and evaluation of subsequent reduction activities, and the management history can be used as countermeasure planning data for new medical malpractice measures.
Further, the information can be disclosed or shared between hospitals or a medical error data bank and used as a basis for mutual information exchange. The medical errors listed in this manner are sorted out based on the likelihood of occurrence based on the evaluation criteria, and a countermeasure for medical errors with a specific rank or higher is drafted and added to the corresponding record in the database (A-3 target screening) process). According to the ranking, medical malpractice for planning a countermeasure activity is selected, but all the countermeasure activities may be planned and practiced. When planning action for all medical malpractice,
(Ranking threshold) is the lowest rank.

Here, ranking in the process of selecting A-3 objects is particularly important. Therefore, in the present invention, (a) medical error consists of three types of errors at the time of steady state, errors at the time of emergency and errors at the time of abnormalities, and ranks the possibility of occurrence of each medical error according to the type based on the evaluation criteria; and (b) There are three types of evaluation criteria, one for each medical practice, each medical care instruction system, and each management and administration system, and the likelihood of occurrence of each medical error is ranked based on the evaluation criteria for each type. (a) Classification of medical malpractice
To grasp the contents of each medical error in more detail and improve the reliability of ranking based on the evaluation criteria. In addition, (b) the classification of evaluation criteria is to classify multifaceted medical practices into individual acts viewed from various aspects (hospital managers, doctors or nurses, etc.), and to describe the contents of medical malpractice viewed from each. It has the meaning of clarifying and facilitating the planning of countermeasures appropriate to each aspect. Such classification of medical malpractice and classification of evaluation criteria has the function of improving the accuracy of ranking and increasing the effectiveness of the system of the present invention.

[0007] The B countermeasure practicing process is a stage in which a planned countermeasure activity is carried out. For example, if the classification of medical errors or evaluation criteria is used as described above, each aspect (hospital manager, doctor or nurse, etc.) Therefore, there are different approaches for each type of action, and each action will be implemented individually.
In particular, when multiple people implement different countermeasures, it is important to add the results of these countermeasures to the corresponding records in the database, in addition to mutual confirmation, when evaluating the results of countermeasures in the C activity evaluation process. It is. The evaluation of the result of this countermeasure activity is an opportunity for review of the countermeasure activity itself and review of specific measures of the countermeasure activity. D The process of reflecting results is a step in reviewing the current medical practice for medical errors of a specific rank or higher after implementing and evaluating countermeasure activities. If the probability of medical errors at this stage is lower than the specific rank in the ranking, it can be improved. In order to reduce the possibility of occurrence of remaining medical errors, the cycle is repeated again from the A countermeasure planning process.
In the second and subsequent cycles, the A-1 policy creation process is unnecessary unless there is a special change, and the A-2 current status confirmation process can be omitted if no new medical error is found.
That is, the process starts from the A-3 target selection process.

[0008]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a flowchart showing one cycle based on the system of the present invention, FIG. 2 is a flowchart showing classification of medical errors identified by error type and evaluation criteria, and FIG. 3 is a screen display showing an example of the database 1 created. FIG. 4 is a system configuration diagram in a hospital constituting the present system. The main point of the present invention is to repeat the four steps A to D. This example is merely an example, and the system configuration (paper-based or computer-based) or database based on the scale of the hospital and the medical improvement policy to be launched first. The aspect (single hospital or mutual use of multiple hospitals) also changes greatly.

In the A-measures planning process, as shown in FIG. 1, first, a medical improvement policy is determined in an A-1 policy creation process. Hospitals include specialized hospitals and general hospitals, and the specialized hospitals also have different medical treatments to be improved for each field. Therefore, this medical improvement policy will determine the direction of the entire system. In deciding this medical improvement policy, it is important to understand the actual medical environment, and a specialized countermeasure team may be formed. It gives a good impression, and it can be expected that this good impression will make the system work better.

[0010] Next, in the A-2 current status confirmation process, the meaning of the actual medical environment that has been grasped is confirmed to identify specific medical errors and to specify the possibility of occurrence thereof. Clarify requirements. As shown in FIG. 2, medical errors can be first classified by error type, then ranked by evaluation criteria, and the likelihood that a countermeasure activity should be planned can be ranked. The ranking may be based on the type of error or evaluation criteria, or may be integrated with all medical errors. Once the specific medical errors have been identified and the likelihood of occurrence has been identified, the basic database 1 (see FIGS. 3 and 4) can be constructed at this stage. A-3
In the countermeasure selection process, medical errors with a specific rank or higher are selected,
After taking the countermeasure activities and specifying them in the database 1, a system corresponding to each medical malpractice will be constructed and the countermeasure activities will be specifically practiced. The database 1 clarifies the response to an emergency by specifying the person in charge of each of the countermeasure activities, results, and evaluations.

In this example, as shown in FIG. 3, a measure for medical malpractice of rank B or higher is made by ranking, and B
Implement the steps after the measures implementation process. For this reason, the No. 3 medical malpractice that has been ranked C has not decided on the person in charge. The classification of the medical errors to be handled based on the ranking as described above has an effect of renewing recognition of the importance of each medical error and effectively reducing the medical errors while reducing the labor for devoting to the medical errors. For medical errors of rank C or lower that are excluded from the target in the first cycle, the ranking changes during the repetition of this system, and countermeasure activities may be planned in the next cycle or later. It is also desirable to register in the database any low-ranking medical errors for which no countermeasures have been formulated, including the meaning as a material for medical errors. These databases are
When disclosed to the outside, it is significant as a basis for mutual information provision between hospitals.

In the B-measure implementation process, the system of each countermeasure activity and the sharing of responsibilities within the system are clarified mainly by the person in charge of the countermeasure activity identified in the database 1,
Implement countermeasures while training, awareness, and cultivating skills within each system, and discussing and communicating with each other within the system. The practice of this countermeasure activity is documented and managed as data or a document on a computer by writing results in the database 1. The above management is performed not only during the implementation of the countermeasure activities, but also after the completion of the countermeasure activities and after the evaluation is issued. Make planning activities easier.
Also, it is preferable to manage each other's correspondence within the system as appropriate in the practice of actual countermeasure activities. other than this,
Regarding medical malpractice and countermeasures that are the target of countermeasures, sudden emergencies can be considered, so it is necessary for each system to prepare for and respond to the emergency. Preparation and response to this emergency may be determined in advance as the content of the countermeasure activity and incorporated in the database 1.

The practice of each countermeasure activity may be repeated many times within one cycle in the system of the present invention, or may be completed at once. It is most preferable that the results of the countermeasure activities be entered in the database 1 for each unit of practice, and that each be evaluated. That is, when the practice is repeated, the results are entered and evaluated each time, and when the practice is completed once, the results are entered once and evaluated. If it is within the period of one cycle, it is preferable to continuously monitor whether or not the target medical error has occurred even after receiving the evaluation after completing the practice.

In the C activity evaluation process, the above-mentioned measures are implemented for each practice unit, and the contents and results of the measures are checked based on the results of the measures, and if necessary, the measures themselves are corrected. Or take corrective action to reduce the likelihood of targeted medical malpractice separately from response activities. The evaluation also includes determining the effect of the countermeasure activity from the results of the countermeasure activity, and continuously monitoring the sustainability of the effect. Furthermore, it is better to audit the overall efforts in terms of the efficiency of the system. Regarding these evaluations,
It is preferable that the information is sequentially reflected in the database 1.

Since the period required for each countermeasure activity varies, it is not always possible to end the countermeasure activity in the same row. However, basically, the end of one cycle is determined first, and the D result is reflected at this end. Perform the process. Here, based on the results and evaluations obtained through the countermeasure activities, corrective or preventive measures for accidents, accident triggers, and nonconformities at each site are taken. It is possible. Thus 1
The cycle ends, but depending on the state of the D result reflection process, the next cycle will start from either the A-1 countermeasure planning process, the A-2 current status confirmation process, or the A-3 target selection process. Become. A-1 countermeasure planning process and A-
2 When returning to the current status confirmation process, a database for the next cycle is constructed by appending or diverting to the previous database, and A
To return to the -3 target selection process, the previous database will be used. These databases are saved for each cycle and used as materials for medical improvement at a later date, and can be shared with hospitals or medical error data banks, etc., and can be shared widely by exchanging information with external medical institutions. Can contribute to planning.

In the database 1, the electronic data format stored in the server 3 on the computer network 2 (intranet or the Internet) is most convenient from the viewpoint of management and disclosure to the outside. For example, as shown in FIG. 4, a database 1 is provided on a server 3 managed by a manager, and doctors a and b and nurses a to c check the database 1 through a client 4 (computer or mobile terminal), respectively. it can. In such a system construction using the computer network 2, there is an advantage that each person can enter a result, an evaluation, and browse it anytime and anywhere through his or her computer or mobile terminal. If necessary, if the access restriction to the database 1 is provided, only the necessary contents can be entered and browsed, so that the flow of information can be easily organized. vice versa,
Opening it widely to the outside allows more people to share information about medical malpractice, which is preferable from the viewpoint of safety measures.

When the database 1 is set up as the document 5, the database 1 may be filed for each evaluation criterion and circulated for entry and browsing. In the case where the database 1 composed of documents is used, the documents may be periodically collected and separately collected in a storage file so that information is collected in each process constituting one cycle in the system of the present invention. The handling of such a database is not limited, and it may be used with a computer or stand-alone, or it may be used in combination with a computer and a document. It is essential to build a database suitable for the size of the hospital and the policy for improving medical care.

The primary effect of the present invention is to improve the safety aspect of preventing or reducing medical malpractice as seen from the hospital side, and the secondary effect is to provide a sense of security as seen from the patient side. Improvement of healthcare and the cultivation of trust in medical care (especially hospitals) These effects are not obtained as a result by applying the system of the present invention, but are obtained in various modes from each stage of planning and practicing the countermeasures against medical malpractice by applying the system. These gradual effects generally give the patient a sense of security and confidence. Table 1 summarizes the effects seen from the patient side.

[0019]

[Table 1]

[0020]

According to the medical error prevention system of the present invention,
It is possible to reduce the possibility of a temporary medical error and to effectively prevent the medical error. On the one hand, the construction of such a system has the advantage of clarifying the way hospital personnel face medical malpractice, bringing about a change in awareness of medical malpractice, and on the other hand giving patients a sense of security.
The current problem of medical malpractice is largely due to the fact that the medical malpractice prevention system is unclear, as well as the occurrence of medical malpractice itself. The system of the present invention eliminates such ambiguity, realizes a system for suppressing medical malpractice across organizations, and is effective in giving a sense of security not only to hospital personnel but also to patients.

[0021] Further, by stylizing the approach to medical malpractice and defining the procedure, there is an effect that the countermeasure activity for medical malpractice can be carried out efficiently. By setting the type of error and the evaluation criteria, it is possible to appropriately plan a countermeasure against each medical error as a whole while treating medical errors as a whole, and to easily evaluate the implementation. Since a series of these flows can be stored in the database at each stage, there is also an advantage that materials useful for medical improvement can be created. In particular, if such a database is constructed on a computer, it is possible to easily exchange or share information between hospitals or medical error data banks, etc., thereby enabling better countermeasures to be planned or common countermeasures at many hospitals. This can contribute to the reduction of medical malpractice as a whole in the medical community. As described above, the system of the present invention exerts an effect of enabling better provision of medical care by systematically analyzing medical care in hospitals and further promoting cooperation between hospitals.

[Brief description of the drawings]

FIG. 1 is a flowchart showing one cycle based on the system of the present invention.

FIG. 2 is a flow chart for classifying the identified medical errors by error type and evaluation criteria.

FIG. 3 is a front view of a screen display showing an example of a created database.

FIG. 4 is a system configuration diagram in a hospital constituting the present system.

[Explanation of symbols]

 1 Database 2 Computer Network 3 Server 4 Client 5 Document

Claims (3)

[Claims] 1. A medical error that may occur according to a medical improvement policy is identified, a database is created in which the contents of the medical error are made in units of records, and the possibility of occurrence is determined based on the evaluation criteria to be equal to or higher than a specific rank. And the result of the countermeasure activity while planning the countermeasure activity for the medical malpractice and adding it to the corresponding record in the database, and implementing the countermeasure activity to reduce the possibility of occurrence of medical malpractice above a specific rank. A process of adding measures to the corresponding record of the database, a process of evaluating activities to evaluate the results of the above-mentioned activities, a process of reflecting the results of reviewing the current medical practice for medical errors of a specific rank or higher that have been implemented and evaluated. By repeating each process in the order described above, the possibility of medical error is reduced, and the occurrence of medical error is prevented beforehand or Medical malpractice prevention system that reduces toward nothing. 2. The medical medical system according to claim 1, wherein the medical errors are classified into three types: errors at a normal time, errors at an emergency, and errors at an abnormal time, and the probability of occurrence of each medical error is ranked based on the evaluation criteria. Error prevention system. 3. The evaluation criteria are classified into three types: medical treatment, medical instruction system, and management and operation system, and rank the probability of occurrence of each medical error based on the evaluation criteria for each type. Medical error prevention system as described.