JP5938769B2 - Medical care support program and medical care support device - Google Patents

Description

  This case relates to a medical care support program and a medical care support device.

  Although accidents or other accidents do not occur, it is possible to prevent accidents from occurring by collecting and managing events that have some potential danger. Such an event originates from “missing” or “missing” and is also referred to as a so-called “missing hat” case.

  In a medical and nursing care system (hereinafter simply referred to as a nursing care system), a case record in which daily actions are written by a staff member is created. Case records may contain near-miss cases. However, staff often are not obliged to record incidents of near-misses, so incidents of near-misses are often not collected. Therefore, there is a technique for collecting near-miss cases by determining whether the case is a near-miss case from a keyword included in the case record (see, for example, Patent Document 1).

  For near-miss cases, measures are taken by examining countermeasures and disseminating the results of the investigation to the site. In addition, the method of making a countermeasure and a follow follow reliably about the submitted near-miss example is known (for example, refer patent document 2).

JP 2011-210187A JP 2004-280313 A

  Even when measures are taken for a near-miss case, a similar near-case may occur. In this case, since the countermeasure is considered to be incorrect, there is a possibility that future accidents cannot be prevented unless the countermeasure is reconsidered.

  However, in the techniques of Patent Documents 1 and 2, it is impossible to determine whether or not a near-miss case requiring improvement of such a countermeasure has occurred, and to notify the user of the system.

  Therefore, this case has been made in view of the above problems, and an object thereof is to provide a medical care support program and a medical care support device that can automatically identify incident information that requires improvement of countermeasure information. To do.

The medical care support program described in this specification accepts information related to medical care or care , and corresponds to information related to medical care or care, incident information that may lead to an accident related to the medical care or care, and the incident information. With reference to the storage unit that stores the countermeasure information indicating the countermeasure in association with each other, the medical unit or the nursing care information that has a similarity degree equal to or greater than a predetermined value with respect to the received medical or nursing care information is extracted from the storage unit When the countermeasure information corresponding to the extracted incident information of the medical or care-related information is registered, the medical care support program for displaying the countermeasure information as countermeasure information that needs improvement and causing the computer to execute the process It is.

The medical care support device described in the present specification receives information related to medical care or care , and corresponds to the information related to medical care or care, incident information that may lead to an accident related to the medical care or care, and the incident information. With reference to the storage unit that stores the countermeasure information indicating the countermeasures in association with each other, the medical unit or the nursing care information whose similarity to the received medical or nursing care information is a predetermined value or more is extracted from the storage unit. A processing unit; and a notification unit that displays the countermeasure information as countermeasure information that needs to be improved when countermeasure information corresponding to the extracted incident information of the medical or care-related information is registered . .

  The medical care support program and the medical care support device described in the present specification have an effect that it is possible to automatically specify incident information that requires improvement of countermeasure information.

It is a figure showing roughly the composition of the medical care support system concerning one embodiment. FIG. 2A is a diagram illustrating a hardware configuration of a server, and FIG. 2B is a diagram illustrating a hardware configuration of an administrator terminal and a caregiver terminal. It is a functional block diagram of a server. It is a figure which shows an example of a case recording screen. It is a figure which shows an example of case recording DB. It is a figure which shows an example of a near miss selection master. It is a figure which shows an example of near-miss management DB. It is a figure which shows an example of the correction notification master. It is a figure which shows an example of countermeasure DB. It is a figure which shows an example of a near-miss edit screen. It is a figure which shows an example of a countermeasure registration screen. It is a flowchart which shows a registration process. It is a figure which shows a near miss possibility list. It is a flowchart which shows a recurrence notification list registration process. It is a figure which shows a recurrence notification list. It is a flowchart which shows a near miss case additional registration process. It is a flowchart which shows the content replenishment process of a near-miss example. It is a flowchart which shows the registration process to countermeasure DB. It is a flowchart which shows the recurrence notification list registration process which concerns on a modification.

  Hereinafter, one embodiment of a medical care support system will be described in detail with reference to FIGS. FIG. 1 schematically shows the configuration of a medical care support system 100 according to the present embodiment.

  The medical care support system 100 is a system used in, for example, a care facility, and includes a server 10 as a medical care support device, an administrator terminal 60, and a care worker terminal 70 as shown in FIG. . The server 10, the manager terminal 60, and the care worker terminal 70 are connected to a network such as the Internet or a LAN (Local Area Network).

  The server 10 is a server installed inside the nursing facility or outside the nursing facility, and performs various processes related to nursing. As an example, the server 10 may receive a case record (record of daily care examples) input from the caregiver terminal 70 by the caregiver, a near-miss case extracted from the case record, and a quality manager from the administrator terminal 60. Holds various data such as countermeasure information for incident incident cases. Further, the server 10 performs predetermined processing based on the input case record, and transmits the processing result to the manager terminal 60 and the caregiver terminal 70. The near-miss case means incident information (case) that may lead to an accident related to nursing care.

  Here, the server 10 has a hardware configuration as shown in FIG. As shown in FIG. 2A, the server 10 includes a CPU 90, a ROM 92, a RAM 94, a storage unit (HDD (Hard Disk Drive)) 96, a network interface 97, a portable storage medium drive 99, and the like. Each component of the server 10 is connected to a bus 98. In the server 10, the CPU 90 executes a program (medical care support program) stored in the ROM 92 or the HDD 96 or a program (medical care support program) read by the portable storage medium drive 99 from the portable storage medium 91. Thus, the function of each unit in FIG. 3 is realized.

  The manager terminal 60 is a terminal used by the quality manager of the care facility, and is a terminal used to browse various data stored in the server 10 and to input data on measures against near-miss cases. is there. The caregiver terminal 70 is a terminal used by a person who actually performs care (caregiver), and is a terminal used for recording a case record in daily care as a case record or performing an input regarding a near-miss case. It is.

  Here, the manager terminal 60 and the care worker terminal 70 have a hardware configuration as shown in FIG. As shown in FIG. 2B, the manager terminal 60 and the caregiver terminal 70 are composed of a CPU 190, a ROM 192, a RAM 194, a storage unit (HDD in this case) 196, a network interface 197, a display unit 193, an input unit 195, and A portable storage medium drive 199 and the like are provided, and each component of the terminals 60 and 70 is connected to a bus 198. Note that the display unit 193 includes a liquid crystal display or the like, and the input unit 195 includes a keyboard, a mouse, or the like.

  FIG. 3 shows a functional block diagram of the server 10. As illustrated in FIG. 3, the server 10 is configured such that the CPU 90 executes the program, thereby causing the case recording processing unit 12, the near-miss extracting unit 14 as a determination unit and a storage processing unit, the recurrence determination unit 16 as a calculation unit and a specification unit. And the function of the medical care information storage registration part 18 as a notification part is implement | achieved. In FIG. 3, various DBs and masters stored in the HDD 96 and the like are also illustrated.

  The case record processing unit 12 displays, for example, a case record screen as shown in FIG. 4 on the display unit 193 of the care worker terminal 70. In addition, when the case record processing unit 12 receives data (example) input from the caregiver via the input unit 195 of the caregiver terminal 70 on the screen, the input data (example) is input. Is stored in the case record DB 20 as a medical care information storage unit.

  Here, the case recording screen of FIG. 4 is a screen generated for each user (person on the side receiving care), and can input the implementation content, physical state and daily life operation status, and reporter ID for each time. It is a screen. The case record screen is provided with an update button, a cancel button, and a delete button. When the care worker presses the update button, the case record processing unit 12 updates the contents (newly input). The process of storing the case) in the case record DB 20 is executed.

  The case record DB 20 has a data structure as shown in FIG. Specifically, as shown in FIG. 5, the case record DB 20 includes “date”, “time”, “execution content”, “physical state and daily life operation status”, “reporter ID”, “user ID”. ”, Each field. In each of these fields, data (examples) input on the case recording screen of FIG. 4 are stored.

  Returning to FIG. 3, the near-miss extraction unit 14 calculates the near-miss reference point of the case stored in the case record DB 20 by using the near-hat selection master 30 that stores the criteria for determining the possibility of being a near-miss case. Here, the near-miss reference point means an index for determining whether or not the case stored in the case record DB 20 is highly likely to be a near-miss case. Further, the near-miss extracting unit 14 determines whether the case stored in the case record DB 20 is a case that should be automatically added to the near-hat management DB 22 as the incident information storage unit based on the calculated near-miss reference point. Determine if it is a candidate case. The near-miss extracting unit 14 adds cases to be automatically added to the near-miss management DB 22 and registers examples of addition candidates in a “possible near-miss possibility list” (see FIG. 13) described later. The near-miss extraction unit 14 transmits a near-miss possibility list to the registration unit 18.

  Here, as shown in FIG. 6, the near-miss selection master 30 is a master that determines the near-miss reference point, and a master that determines the point addition criteria for keywords, places, time zones, problematic users, and problematic staff. Have Whether or not each master in FIG. 6 is used can be determined by, for example, a quality manager. In the example of FIG. 6, since “target: □” is described in the upper right of the time zone master, it is assumed that the master is not used. On the other hand, the other masters are described as “target: ■” in the upper right of each master, and it is assumed that the master is used. Also, the contents of each master included in the near-miss selection master 30 can be added or changed as appropriate by, for example, a quality manager. The details of the near miss selection master 30 will be described later.

  Further, the near-miss management DB 22, as shown in FIG. 7, “occurrence date”, “occurrence time”, “serial number”, “reporter ID”, “user ID”, “occurrence location”, “impact” , “Situation”, “specific content influence”, “response after occurrence”, “cause background”, and “explanation response content to user family”.

  Returning to FIG. 3, the recurrence determining unit 16 calculates the correction notification hit rate of the case registered in the near-miss management DB 22 based on the correction notification master 32. Here, the correction notification hit rate is an index indicating the degree of similarity between a case registered in the near-miss management DB 22 and a near-miss case where measures have been taken in the past. Therefore, the recurrence determining unit 16 determines whether or not the case registered in the near miss management DB 22 is similar to the near miss case for which measures have been taken in the past, using the calculated correction notification hit rate. Further, the recurrence determining unit 16 notifies the administrator terminal 60 of a case where a near-miss case is similar to a near-miss case for which measures have been taken in the past (when the near-miss case has recurred). To do.

  Here, as shown in FIG. 8, the correction notification master 32 is a master that determines the correction notification hit rate, and a master that determines the criteria for adding points regarding keywords, locations, time zones, problematic users, and problematic staff. And a corrective recurrence period. Whether or not to use each master in FIG. 8 can be determined by, for example, a quality manager. In addition, the contents of each master included in the correction notification master 32 can be added or changed as appropriate by, for example, a quality manager.

  In response to a request from the administrator terminal 60 or the caregiver terminal 70, the registration unit 18 displays the near miss possibility list in FIG. 13, the near hat edit screen in FIG. 10, and the countermeasure registration screen in FIG. Is displayed on the display unit 193. Also, the registration unit 18 updates the near miss management DB 22 and the countermeasure DB 24 as the countermeasure information storage unit using the data input on the screens of FIGS. 10 and 11.

  Here, the countermeasure DB 24, as shown in FIG. 9, “occurrence date”, “occurrence time”, “serial number”, “administrator ID”, “risk evaluation”, “risk prediction”, “need for improvement” ”,“ Utilization for education and training ”,“ Countermeasure enforcement date ”,“ Countermeasure ”,“ Administrator comment ”. Here, the “occurrence date”, “occurrence time”, and “serial number” fields are also included at the top of the near-miss management DB 22 in FIG. That is, it can be said that these three fields are associated with each record of the countermeasure DB 24 and each record of the near miss management DB 22. Thereby, it can be judged from the relationship with the countermeasure DB 24 whether or not a countermeasure is taken for each case stored in the near miss management DB 22.

  In the “risk assessment” field, whether or not risk assessment has been performed (“present” or “none”) is entered. In the “risk prediction” field, whether or not risk prediction is possible is entered. In the “necessity of improvement” field, whether or not improvement is necessary is entered. In the field “Utilization for Education and Training”, whether or not it can be used for education and training is entered. The date when the countermeasure was taken is entered in the “Countermeasure Date” field. In the “Countermeasure” field, the content of the measure taken by the quality manager is entered. In addition, a comment of the quality manager is input to “management comment”.

  Next, the processing of the server 10 according to the present embodiment will be described in detail along the flowcharts of FIGS. 12, 14, and 16 to 18 with reference to other drawings as appropriate.

(registration process)
First, registration processing by the server 10 will be described with reference to the flowchart of FIG.

  In the process of FIG. 12, in step S <b> 10, the case record processing unit 12 waits until a request to display a case record screen is issued from the care worker terminal 70. In this case, the case record processing unit 12 proceeds to step S12 when a request to display the case record screen is issued from the care worker terminal 70.

  When the process proceeds to step S12, the case recording processing unit 12 generates a case recording screen (FIG. 4) corresponding to the date on which the display request is issued and displays it on the display unit 193 of the care worker terminal 70. In this case, the person in charge of nursing care enters the case such as points that have been noticed in nursing care on the case record screen for each time and content of implementation in the “Physical condition and daily life movement status” column, and presses the update button. Do.

  Next, in step S14, the case recording processing unit 12 determines whether or not the caregiver has recorded on the case recording screen (whether or not data has been input and the update button has been pressed). If the determination here is negative, that is, if the update button has not yet been pressed, the process proceeds to step S30, and the case recording processing unit 12 determines whether or not the case recording screen has ended. When judgment here is denied, it returns to step S14.

  On the other hand, if the determination in step S14 is affirmative, the process proceeds to step S16, and the case record processing unit 12 registers newly input data (case) in the case record DB 20.

  Next, in step S18, the near-miss extracting unit 14 executes a near-miss determination process. Specifically, the near-miss extraction unit 14 calculates a near-miss reference point for the case registered in the case record DB 20 using the near-miss selection master in FIG. For example, in the case of the third line (7:00) in the case record DB 20 of FIG. 5, the near miss extraction unit 14 adds the keyword “difficult”, so 1 point is added, and the problematic staff “001” is the reporter. Therefore, the near-miss reference point is calculated in a point addition format such as 1 point addition. Then, the near-miss extracting unit 14 refers to the master (upper left of FIG. 6) regarding the near-miss reference point of the near-miss selection master 30, and based on the total points of the near-miss reference points, the case may be “near-miss confirmation” or “near-miss” ”Or neither.

  Next, in step S20, the near-miss extracting unit 14 determines whether or not it is determined that “near-miss” has been determined in step S18. When judgment here is affirmed, it transfers to step S22. In step S <b> 22, the near-miss extracting unit 14 registers the case determined to be near-miss confirmation in the near-miss management DB 22. In this case, for example, as shown in the bottom row of FIG. 7, when a new case is registered in the near-miss management DB 22, data is registered in the field corresponding to the field of the case record DB 20, and the non-corresponding field is blank. It becomes. In addition, after the process of step S22, it transfers to step S28.

  On the other hand, if the determination in step S20 is negative, that is, if it is not determined that “near incident is confirmed” in step S18, the near-miss extracting unit 14 proceeds to step S24. In step S24, the near-miss extracting unit 14 determines whether or not there is a possibility of near-miss in step S18. If the determination is negative, the process proceeds to step S30. If the determination is positive, the process proceeds to step S26.

  When the process proceeds to step S26, the near-miss extraction unit 14 registers the case in the near-miss possibility list. Here, as shown in FIG. 13, “occurrence date”, “time”, “execution content”, “physical state and daily living operation status” of the case are registered in the near miss possibility list. Among these, in the “situation” column, the contents of “physical state and daily life movement situation” of the case record DB 20 are input. It is assumed that a list of potential near misses is created for each reporter ID.

  Next, in step S28, the recurrence determining unit 16 executes a subroutine for the recurrence notification list registration process. In this case, the recurrence determining unit 16 executes processing according to the flowchart of FIG.

  In the process of FIG. 14, first, in step S40, the recurrence determining unit 16 sets (initializes) a parameter i indicating the number of recurrences to 0. Next, in step S42, the recurrence determining unit 16 extracts the first record (case) of the near miss management DB 22.

  Next, in step S43, the recurrence determining unit 16 determines whether or not the countermeasure information of the extracted record is registered in the countermeasure DB 24. In this case, the recurrence determining unit 16 determines whether or not the same thing as the “occurrence date”, “occurrence time”, and “serial number” of the extracted record in the near miss management DB 22 exists in the countermeasure DB 24. . If the determination in step S43 is negative, that is, if the extracted record (a near miss case) has not yet been taken, the process proceeds to step S50. If the determination is affirmative, step S44 is performed. Migrate to

  When the process proceeds to step S44, the extracted record (case) is compared with the case newly input on the case recording screen to identify matching items, and a correction notification is made of the total points of the identified items. Calculate with reference to the master 32.

  Next, in step S46, the recurrence determining unit 16 determines whether or not the correction notification hit rate is “high”. In this case, the recurrence determination unit 16 determines whether or not the hit rate calculated in step S44 is “high” based on the correction notification hit rate master (the upper left master in FIG. 8) of the correction notification master 32. . When judgment here is denied, it transfers to step S50. On the other hand, if the determination in step S46 is affirmative, the process proceeds to step S48. When the process proceeds to step S48, the recurrence determining unit 16 increments the parameter i indicating the number of recurrences by 1 (i ← i + 1), and the process proceeds to step S50.

  In step S50, the recurrence determining unit 16 determines whether or not all records within the corrective recurrence period have been extracted. Here, it is assumed that the correction recurrence period is predetermined (see the lower left in FIG. 8). As shown in FIG. 8, when 6 months is set as the correction recurrence period, the determination in step S50 is affirmed when the extraction of all the records from the present to 6 months ago is completed. . On the other hand, if extraction of all the records from the present to six months ago is not completed, the determination in step S50 is denied and the process proceeds to step S52. In step S52, the recurrence determination unit 16 extracts the next record in the near miss management DB 22, and returns to step S43. Thereafter, the processing and determination of steps S43 to S50 are repeated.

  On the other hand, if the determination in step S50 is affirmed, the recurrence determination unit 16 proceeds to step S54. In step S54, the recurrence determining unit 16 determines whether i is greater than zero. If the determination here is negative, the entire process of FIG. 14 is terminated, and the process proceeds to step S30 of FIG. On the other hand, if the determination in step S54 is affirmative, the process proceeds to step S56. In step S56, the recurrence determination unit 16 registers the new case record case in the recurrence notification list together with the number i of the correction notification hit rate “high”. Here, it is assumed that the recurrence notification list is a list as shown in FIG. The recurrence notification list in FIG. 15 stores “selection (presence / absence)”, “occurrence date”, “situation”, “number of recurrences”, and “previous correction date”. In the “situation” column, the contents of “physical state and daily life movement situation” of the case record DB 20 are input. The value of parameter i is entered in the “number of recurrences” field. In the “last correction date” column, the date (“Countermeasure enforcement date” in FIG. 9) when the quality manager took measures for the most recent similar near-miss case is entered. As described above, after the process of step S56 is performed, the process proceeds to step S30 in FIG.

  Returning to FIG. 12, when the process proceeds to step S30, the case recording processing unit 12 determines whether or not the case recording screen is ended. If the determination here is negative, the display returns to step S14 while continuing to display the case recording screen, and the same processing as described above is repeated. On the other hand, if the determination in step S30 is affirmative, the display of the case recording screen is terminated, the process returns to step S10, and the same processing as described above is repeated.

  By performing the process as described above, the caregiver inputs the case record on the case record screen, and stores the case in the case record DB 20 and registers the case in the near-miss management DB 22 at the timing when the update button is pressed. It is possible to perform registration to the list of possible near-miss and registration to the recurrence notification list.

(Near incident incident registration process)
Next, a near-miss case addition registration process will be described with reference to FIG. This process is a process of additionally registering a case registered in the near-miss possibility list (FIG. 13) in the near-miss management DB 22 as a near-miss case. The process of FIG. 16 is a process executed by the registration unit 18.

  In the process of FIG. 16, first, in step S <b> 60, the registration unit 18 waits until a display request for a near-miss possibility list is issued. In this case, when a display request is issued from the care worker terminal 70, the process proceeds to step S62.

  If transfering it to step S62, the registration part 18 will display the near miss possibility possibility list | wrist (FIG. 13) corresponding to the care worker who made the display request. The care worker selects a case included in the list in the displayed near-miss possibility list (select any case in FIG. 13 and press the execution button).

  Next, in step S64, the registration unit 18 determines whether or not a case has been selected. If the determination here is affirmative, the process proceeds to step S66, and the selected case is registered (additional registration) in the near-miss management DB 22, and the selected case is deleted from the near-miss possibility list, Control goes to step S68. On the other hand, if the determination in step S64 is negative, the process directly proceeds to step S68.

  If transfering it to step S68, the registration part 18 will judge whether the display termination request | requirement of the list | wrist with a near-miss possibility list | wrist was issued from the care worker terminal 70. If the determination is negative, the process returns to step S64, and the processing and determination of steps S64 to S68 are repeated. On the other hand, if the determination in step S68 is affirmative (when the end button in FIG. 13 is pressed), the display of the list of possible near-misses is terminated, the process returns to step S60, and the processes in steps S60 to S68 are performed. Repeat judgment.

  Through the above processing, the registration unit 18 can register (additionally register) the case registered in the near miss possibility list in the near hat management DB 22 in accordance with the input of the caregiver. In other words, in the present embodiment, additional registration in the near-miss management DB 22 of cases registered in the near-miss possibility list is left to the caregiver himself / herself.

(Content replenishment processing of near-miss cases)
Next, the content replenishment process of the near-miss example will be described along the flowchart of FIG. This process is a process for realizing content replenishment performed by the person in charge of care to enrich the content of the case registered in the near-miss management DB 22 (FIG. 7). Note that the process of FIG. 17 is a process executed by the registration unit 18.

  In the process of FIG. 17, first, in step S80, the registration unit 18 waits until a near-miss list display request is issued. In this case, when a display request is issued from the caregiver terminal 70, the registration unit 18 proceeds to step S82.

  If transfering it to step S82, the registration part 18 will display a near-miss list. It is assumed that the near-miss list is a list in which only the fields necessary for identifying near-miss cases are extracted from the near-hat management DB 22 of FIG. It is assumed that the caregiver selects one near-miss case to be edited or added from the near-miss list displayed.

  Next, in step S84, the registration unit 18 determines whether a near-miss example has been selected. When judgment here is denied, it transfers to step S92. On the other hand, if the determination in step S84 is affirmative, the process proceeds to step S86.

  When the process proceeds to step S86, the registration unit 18 displays a near-miss edit screen (FIG. 10) on the terminal 70 of the care worker who has selected the near-case example. Here, it is assumed that the near-miss edit screen of FIG. 10 has the same input field as the field of the near-miss management DB 22. The caregiver inputs data related to a near-miss case in these input fields.

  Next, in step S88, it is determined whether editing on the near-miss edit screen has been completed (whether the update button in FIG. 10 has been pressed). While the determination here is denied, step S88 is repeated, but when the determination in step S88 is affirmed, the process proceeds to step S90.

  In step S90, the registration unit 18 updates the near-miss management DB 22 with the content input on the near-miss edit screen. Thereafter, the process proceeds to step S92.

  In step S92, it is determined whether a display end request for the near-miss edit screen has been issued. If the determination is negative, the process returns to step S84, and the processes and determinations of steps S84 to S92 are repeated. On the other hand, if the determination in step S92 is affirmative, the process returns to step S80, and the processes and determinations in steps S80 to S92 are repeated.

  With the above processing, the registration unit 18 can replenish the contents of the near-miss management DB 22 in accordance with the input of the caregiver.

(Registration processing in the countermeasure DB)
Next, registration processing in the countermeasure DB 24 will be described with reference to the flowchart of FIG. This process is a process for registering countermeasure information on a near-miss case registered in the recurrence notification list (FIG. 15) in the countermeasure DB 24 in response to an input from the quality manager. The process of FIG. 18 is a process executed by the registration unit 18.

  In the process of FIG. 18, first, in step S <b> 102, the registration unit 18 stands by until a process start request is issued at the administrator terminal 60. The process start request is issued, for example, when the quality manager selects an icon or the like for starting up the screen of the medical care support system 100.

  In step S104, the registration unit 18 determines whether the recurrence notification list (FIG. 15) is not empty. If the determination here is negative (empty), the process returns to step S102. On the other hand, if the determination in step S104 is affirmative (if it is not empty), the process proceeds to step S106.

  In step S106, the registration unit 18 displays the recurrence notification list in FIG. 15 on the display unit 193 of the administrator terminal 60. The quality manager selects a case for which countermeasure information is to be registered from the displayed relapse notification list, and presses the execution button. Here, the “recurrence count” of each case in the correction recurrence period is also described in the recurrence notification list. Therefore, for example, the quality manager can determine that it is necessary to take measures as soon as the number of recurrences in the correction recurrence period increases (the frequency is high), and can select a case.

  Next, in step S108, the registration unit 18 determines whether one case in the recurrence notification list has been selected. If the determination is negative, the process proceeds to step S116. If the determination is positive, the process proceeds to step S110.

  When the process proceeds to step S110, the registration unit 18 displays a countermeasure registration screen (FIG. 11) on the display unit 193 of the administrator terminal 60. Here, it is assumed that the same entry field as the field of the countermeasure DB 24 exists in the countermeasure registration screen of FIG. The quality manager inputs information on measures against the near-miss case in these input fields.

  Next, in step S112, it is determined whether or not the input on the countermeasure registration screen has been completed (whether or not the update button in FIG. 11 has been pressed). While the determination here is negative, step S112 is repeated, but if the determination in step S112 is affirmative, the process proceeds to step S114.

  If transfering it to step S114, the registration part 18 will update countermeasure DB24 with the content input into the countermeasure registration screen. The registration unit 118 newly registers countermeasure information regarding a new near-miss case in the countermeasure DB 24. In addition, the registration unit 118 overwrites countermeasure information (measurement information that needs improvement) already registered in the countermeasure DB 24. Furthermore, the registration unit 18 deletes the case in which the countermeasure information is registered in the countermeasure DB 24 from the recurrence notification list. Thereafter, the process proceeds to step S116.

  In step S116, it is determined whether a request to end display of the countermeasure registration screen has been issued. If the determination is negative, the process returns to step S108, and the processes and determinations of steps S108 to S114 are repeated. On the other hand, if the determination in step S116 is affirmative, the process returns to step S102, and the processes and determinations in steps S102 to S116 are repeated.

  With the above processing, the registration unit 18 can store the countermeasure information for the near-miss case input by the quality manager in the countermeasure DB 24. Note that the information stored in the countermeasure DB 24 is displayed on the display unit 193 of each care worker terminal 70 at an appropriate timing for enlightenment to the care worker. The information stored in the countermeasure DB 24 can be appropriately viewed by a caregiver or a quality manager.

  Even when the recurrence notification list is empty, the quality manager needs to register the countermeasure information related to the near-miss case newly registered in the near-miss management DB 22 in the countermeasure DB 24. In this case, the quality manager causes the registration unit 18 to display a countermeasure registration screen related to the near-miss case registered in the near-miss management DB 22 and input countermeasure information on the screen. Thereby, the registration unit 18 can register the countermeasure information of the new near-miss example in the countermeasure DB 24.

  As described above in detail, according to the present embodiment, the case record input by the caregiver is stored in the case record DB 20, the near-miss case is stored in the near-miss management DB 22, and the countermeasure DB 24 is stored. In addition, countermeasure information corresponding to a near-miss case input by the quality manager is stored. Then, the recurrence determining unit 16 determines the degree of similarity between the case record input by the caregiver and the information stored in the incident management DB 22 in the past and the countermeasure information stored in the countermeasure DB 24 (correction notification). (Hit rate) is calculated, and when the correction notification hit rate is equal to or higher than a predetermined value (when it is high), the countermeasure information is identified as countermeasure information that needs improvement. Thereby, in this embodiment, it is a near-miss case where a new case reappeared due to the similarity between the new case and a past near-miss case where measures are taken (a near-miss case where a countermeasure has been taken) It is possible to automatically identify incidents that need to be reexamined. Therefore, in the present embodiment, it is possible to support the collection work of the incident case that has been recurred by the quality manager and has already been treated (the incident example that needs to be reexamined). In addition, by notifying the quality manager of the identified near-miss case, the quality manager can be urged to review the measures regarding the reoccurring near-hat case.

  In the present embodiment, the recurrence determining unit 16 corrects the cases newly stored in the case record DB 20 and the near-miss cases that have been treated and stored in the near-miss management DB 22 within the correction recurrence period (for example, 6 months). Calculate the notification hit rate. In the recurrence notification list notified by the registration unit 18, the number of times that the correction notification hit rate becomes “high” within the correction recurrence period (for example, 6 months) is also displayed. Thereby, in this embodiment, the quality manager can perform processing based on the recurrence frequency in the correction recurrence period. For example, based on the frequency of recurrence during the correction recurrence period, the quality manager can classify near-miss cases that need to be urgently taken and those that do not need to be handled with priority. .

  In this embodiment, the near-miss criterion 14 indicates whether the case newly stored in the case record DB 20 is a near-miss case based on the near-miss selection master 30 (FIG. 6). Calculate points. Then, the near-miss extracting unit 14 determines “near-miss confirmation” or “possibly near-miss” based on the near-miss reference point, and if it is “near-miss confirmation”, the case is automatically stored in the near-miss management DB 22. If there is a possibility of near-miss, the case is stored in the near-miss management DB 22 according to the selection of the caregiver. Thereby, in this embodiment, when the near-miss reference point is high and it is clear that the case should be stored in the near-miss management DB 22, the near-miss extraction unit 14 automatically stores the case in the near-miss management DB 22, When the near-miss reference point is slightly low and there is a possibility that the incident is not a case that should be stored in the near-miss management DB 22, it is left to the caregiver to determine whether to store the case in the near-miss management DB 22. As a result, it is possible to reduce the burden of registration of cases in the near-miss management DB 22 of caregivers, and to leave a part to the judgment of the caregivers, thereby improving the registration accuracy.

  In the above embodiment, the recurrence determining unit 16 determines whether or not the countermeasure information of the extracted record is registered in the countermeasure DB 24 (step S43 in FIG. 14), and when the determination is affirmed, The case where the correction notification hit rate is calculated has been described. However, the present invention is not limited to this. For example, as shown in FIG. 19, the process of step S47 may be performed instead of the process of step S43 of FIG. In this case, the recurrence determination unit 16 determines whether the countermeasure information of the extracted record is registered in the countermeasure DB 24 when the correction notification hit rate between the extracted record and the new case is “high”. When the determination is affirmed, a new case is registered in the correction notification list. Even if it does in this way, the effect similar to the said embodiment can be acquired.

  In the above embodiment, the recurrence determining unit 16 may add the number of recurrences during the correction recurrence period to the correction notification hit rate. By doing so, it is possible to increase the correction notification hit rate of cases with a high recurrence frequency.

  Moreover, in the said embodiment, it is good also as performing the process (display) according to the period until it recurs. For example, when the period until the recurrence is long, it may be notified that the countermeasure information has been lost. In this case, the fact may be displayed on the recurrence notification list (FIG. 15), or a separate list may be created and displayed.

  In the above embodiment, the case where the processing of step S28 is performed after the processing of steps S22 and S26 in the registration processing of FIG. 12 has been described, but the present invention is not limited to this. For example, the process of step S28 may be executed after step S22, while the process of step S28 may not be executed after step S26. In this case, the same process as step S28 may be performed when the process of step S66 of FIG. 16 is performed.

  In the above embodiment, the case where the parameter i is incremented by 1 when the correction notification hit rate is “high” in step S46 has been described. However, the present invention is not limited to this. For example, the quality manager or the like may change the reference for incrementing the parameter i by 1.

  In addition, although the said embodiment demonstrated that the near-miss example may be registered into the near-miss management DB22 by the near-miss extraction part 14 automatically, it is not restricted to this. For example, the care worker may manually register all near-miss cases.

  In addition, although the said embodiment demonstrated the case where a medical care support system was introduce | transduced into the care facility, it is good also as introducing not only into this but a medical facility.

  The above processing functions can be realized by a computer. In that case, a program describing the processing contents of the functions that the processing apparatus should have is provided. By executing the program on a computer, the above processing functions are realized on the computer. The program describing the processing contents can be recorded on a computer-readable recording medium.

  When the program is distributed, for example, it is sold in the form of a portable recording medium such as a DVD (Digital Versatile Disc) or a CD-ROM (Compact Disc Read Only Memory) on which the program is recorded. It is also possible to store the program in a storage device of a server computer and transfer the program from the server computer to another computer via a network.

  The computer that executes the program stores, for example, the program recorded on the portable recording medium or the program transferred from the server computer in its own storage device. Then, the computer reads the program from its own storage device and executes processing according to the program. The computer can also read the program directly from the portable recording medium and execute processing according to the program. Further, each time the program is transferred from the server computer, the computer can sequentially execute processing according to the received program.

  The above-described embodiment is an example of a preferred embodiment of the present invention. However, the present invention is not limited to this, and various modifications can be made without departing from the scope of the present invention.

In addition, the following additional notes are disclosed regarding the above description.
(Supplementary note 1) Store information related to medical care or care input by the user in the medical care information storage unit,
Store incident information that may lead to accidents related to medical care or nursing care in the incident information storage,
Storing countermeasure information corresponding to the incident information input by the user in the countermeasure information storage unit;
Calculating the degree of similarity between the information related to the medical care or nursing care and the information stored in the incident information storage unit in the past and the countermeasure information stored in the countermeasure information storage unit;
A medical care support program for causing a computer to execute processing for identifying countermeasure information that needs improvement based on the degree of similarity.
(Additional remark 2) Let the said computer further perform the process which notifies a user the countermeasure information which needs the said identified improvement,
In the calculation process, the degree of similarity between the information on the medical care or care and the information stored in the incident information storage unit and stored in the countermeasure information storage unit in the past predetermined period is calculated. And
In the process of specifying, the measure information whose degree of similarity with information about medical care or nursing care is equal to or greater than a predetermined value is specified,
The medical care support program according to appendix 1, wherein in the process of notifying, notification according to the number of the specified countermeasure information is performed.
(Additional remark 3) Based on the criteria for determining the possibility of being the incident information, the computer further executes a process of determining the possibility that the information stored in the medical care information storage unit is the incident information Let
In the process of storing in the incident information storage unit, the information stored in the medical care information storage unit is stored in the incident information storage unit based on the possibility of the incident information or based on the input of the user The medical care support program according to Supplementary Note 1 or 2, characterized by:
(Additional remark 4) Let the said computer further perform the process which notifies a user the countermeasure information which needs the said identified improvement,
In the notification process, a notification corresponding to the time when the countermeasure information corresponding to the information whose similarity with the medical or nursing care information input by the user is equal to or greater than a predetermined value is stored in the countermeasure information storage unit is sent. The medical care support program according to appendix 1, which is performed.
(Additional remark 5) The medical care information storage part which stores the information regarding the medical treatment or care input by the user,
An incident information storage unit for storing incident information that may lead to an accident related to medical care or nursing care;
A countermeasure information storage unit that stores countermeasure information corresponding to the incident information input by the user;
A calculation unit for calculating a degree of similarity between the information on the medical care or the care and the information stored in the incident information storage unit in the past and the countermeasure information stored in the countermeasure information storage unit;
A medical care support apparatus comprising: a specifying unit that specifies countermeasure information that needs improvement based on the degree of similarity.
(Additional remark 6) It further has a notification part which notifies a user of the measure information which needs the improvement specified by the specific part,
The calculation unit calculates a degree of similarity between the medical or nursing care information and information stored in the incident information storage unit and stored in the countermeasure information storage unit in the past predetermined period. ,
The identification unit identifies countermeasure information whose similarity with information related to the medical treatment or nursing care is equal to or greater than a predetermined value,
The medical care support apparatus according to appendix 5, wherein the notification unit performs notification according to the number of the specified countermeasure information.
(Supplementary Note 7) Based on a criterion for determining the possibility of the incident information, a determination unit that determines the possibility that the information stored in the medical care information storage unit is the incident information;
Supplementary note 5 or further comprising: a storage processing unit that stores information stored in the medical care information storage unit in the incident information storage unit based on a possibility of being the incident information or based on an input of the user 6. The medical care support device according to 6.
(Additional remark 8) It further has a notification part which notifies a user of the specified measure information which needs the improvement,
The notification unit performs notification according to a time when countermeasure information whose degree of similarity with information related to medical care or care input by the user is a predetermined value or more is stored in the countermeasure information storage unit. The medical care support apparatus according to appendix 5.

10 servers (medical care support equipment)
14 Near-miss extraction unit (determination unit, storage processing unit)
16 Recurrence determination part (calculation part, specific part)
18 Registration Department (Notification Department)
20 Case record DB (medical care information storage)
22 Near-miss management DB (incident information storage)
24 Countermeasure DB (Countermeasure information storage unit)
30 Near-miss selection master (standard)

Claims (5)

Accept information on medical or nursing care ,
Medical or information about the care, with reference and incident information that might lead to the medical or accident regarding the care, a storage unit that stores in association with countermeasure information indicating countermeasures corresponding to the incident information, accepted Extracting from the storage unit information related to medical care or nursing care that has a degree of similarity equal to or greater than a predetermined value with respect to information related to the medical care or nursing care
When the countermeasure information corresponding to the extracted incident information of the medical or nursing care related information is registered, the countermeasure information is displayed as countermeasure information that needs improvement.
A medical care support program that causes a computer to execute processing. The medical care support program according to claim 1, wherein in the display processing, display is performed in accordance with the number of countermeasure information that needs to be improved . Based on the criteria for determining the possibility of being the incident information, determining the possibility that the received information related to the medical care or the care is the incident information ,
On the basis on the basis of the potentially incident information or the user's input, storing the medical or information regarding the care accepted in the storage unit, according to claim 1 or 2 further execute the processing to the computer Medical care support program. The medical care support program according to claim 1, wherein in the processing to display , notification according to the time when the countermeasure information to be displayed is stored in the storage unit is performed. Receiving medical or information about the care, the information relates to a medical or care, and incident information that could lead to the medical or accident regarding the care, and stored in association with countermeasure information indicating countermeasures corresponding to the incident information With reference to the storage unit, a processing unit that extracts information on the medical treatment or nursing care from which the similarity with the received information on the medical treatment or the nursing care is a predetermined value or more from the storage unit;
When the countermeasure information corresponding to the extracted incident information of the information related to the medical care or the care is registered, a notification unit that displays the countermeasure information as countermeasure information that needs improvement,
A medical care support device comprising:

Images