JP6386751B2 - Medical accident prevention system - Google Patents

Description

  Embodiments described herein relate generally to a medical accident prevention system for managing medical practice.

  In general, when a medical practice such as surgery is performed at a medical site, the details are recorded as a report by a doctor involved in the medical practice. This report may be accompanied by medical examination data, medical images, videos, etc. output from various devices during medical practice.

  However, in the above report, a wide variety of data is often attached regardless of the order of time, and even a specialist such as a doctor cannot confirm and verify the medical procedure after the fact. It is quite difficult.

  In view of this, it is also conceivable to record the state of the medical practice with a video camera and to confirm and verify the procedure of the medical practice based on the recorded moving image. However, such verification has a problem that it is a very time-consuming work because it is necessary to continue to view moving images over a long period of time while analyzing the contents of the medical practice being performed.

  For this reason, various systems that make it possible to easily confirm and verify the procedure of medical practice have been proposed. Manages medical practices including multiple stages achieved by combining multiple events, collects medical equipment and / or status information indicating the human condition related to medical practices in a time-series manner, stage execution order, stage There is one that automatically generates medical start procedure information and medical practice procedure information (see Patent Document 1).

  In order to prevent medical accidents, it is indispensable to organize, organize, and clean the operating room, and it is necessary to arrange medical equipment and medical staff according to the medical practice. However, depending on the progress of medical practice and the occurrence of troubles, there are cases in which the operation is shifted without being maintained because safety is not maintained.

JP 2006-164251 A

  The problem to be solved by the present invention is to solve the above problems and provide a medical accident prevention system that guides medical staff and medical devices during medical practice to a place according to the arrangement plan and facilitates verification after medical practice The purpose is to do.

To achieve the above object, a medical accident prevention system of the present embodiment, medical staff or medical equipment or a surgical planning unit that measures the constant placement plan both medical staff or medical equipment, or both, an arrangement monitoring unit that acquires an actual arrangement, the actual arrangement obtained in the arrangement monitoring unit, and a state determining unit for determining the difference information with the placement plan, based on the previous SL difference information, the medical staff Or a display / device control unit that displays information for guiding the medical device, or both, to a position based on the arrangement plan, and a grid panel that is arranged on the floor and divided into a grid shape. The monitoring unit obtains a grid on the grid panel representing the actual arrangement, and the display / device control unit represents the grid path representing a position based on the arrangement plan. Displaying information the induced grid on Le.

The block block diagram of the medical accident prevention system in 1st Embodiment. The flowchart figure of the medical stage in this embodiment. The table figure which shows the arrangement plan of a medical staff. The table figure which shows the arrangement plan of a medical device. The table figure which shows the required time plan of each medical stage. The table figure which shows difference information. The arrangement | positioning figure of the medical staff and medical device in a 1st medical stage. The arrangement | positioning figure of the medical staff and medical device in a 2nd medical stage. The arrangement | positioning figure of the medical staff and medical device in a 3rd medical stage. The flowchart figure of the surgery plan planning in 2nd Embodiment. The block block diagram of the medical accident prevention system in 3rd Embodiment. The block block diagram of a floor grid panel.

  Hereinafter, embodiments will be described in detail with reference to FIGS. 1 to 12. In the following description, components having substantially the same function and configuration are denoted by the same reference numerals, and redundant description will be given only when necessary.

(First embodiment)
The medical accident prevention system according to the present embodiment shown in FIG. 1 mainly monitors whether a surgical plan planned by the surgical planning system 1 and the surgical planning system 1 that plan a medical practice such as surgery is performed, It is comprised with the surgery monitoring system 2 for preventing.

  The surgical planning system 1 includes a surgical planning unit 11, a plan information storage unit 12, and a surgical plan analysis unit 13.

  The surgery monitoring system 2 includes an arrangement monitoring unit 21, a state determination unit 22, a history information storage unit 23, a display / apparatus control unit 24, and a console 25.

  The operation planning unit 11 divides a series of flow from preparation to completion of medical practice into medical stages representing a plurality of processes based on the arrangement of medical staff and / or medical equipment, and medical treatment during medical practice is performed. Establish a surgical plan that describes the staff and medical device placement plan for each medical stage.

  The plan information storage unit 12 stores the operation plan formulated by the operation plan unit 11, and this operation plan is used to determine whether the actual medical practice is changing as planned.

  The operation plan analysis unit 13 analyzes an optimal arrangement plan from the past operation history stored in the history information storage unit 23 and reflects it in the prepared operation plan.

  The placement monitoring unit 21 acquires the placement of medical staff and / or medical equipment during medical practice. In this embodiment, a video analysis unit 211 that analyzes the arrangement of medical staff and medical devices during a medical practice, an individual identification unit 212 that uniquely identifies the medical staff and medical devices, and voice recognition that recognizes the voice of the medical staff Part 213.

  The video analysis unit 211 analyzes the positions and orientations of medical staff and medical devices by image analysis using videos from a plurality of cameras 214 installed on the upper and side surfaces of the operating room.

  In addition, the individual identification unit 212 uniquely identifies a medical staff and a medical device to which a barcode or an RFID 215 tag is attached by using the barcode reader or the RFID reader 215. Then, the medical staff and the medical device uniquely identified by the individual identification unit 212 are associated with the analysis image of the video analysis unit 211, and the movement and orientation of the medical staff and the medical device are recognized. Furthermore, it is possible to recognize the eyes of medical staff and gestures.

  The voice recognition unit 213 recognizes the voice of the medical staff collected by the medical staff, the operating table, and other microphones attached at predetermined positions, and recognizes the command from the voice recognition. It is also possible to recognize abnormal sounds of patients and medical devices.

  The medical staff and the medical device uniquely identified by the individual identification unit 222 are also associated with the voice recognition of the voice recognition unit 213.

  And the arrangement | positioning monitoring part 21 acquires arrangement | positioning of the medical staff and medical device in a medical act in a predetermined time unit (for example, 1 minute).

  The state determination unit 22 acquires the monitoring information of the medical staff and medical equipment acquired by the placement monitoring unit 21 and obtains difference information from the surgical plan formulated by the surgical planning unit 11.

  The history information storage unit 23 stores the difference information obtained by the state determination unit 22 in association with the surgical plan.

  Based on the difference information obtained by the state determination unit 22, the display / device control unit 24 displays, on the monitor 241, an alert message for the doctor staff who is performing medical treatment and an arrangement position based on the surgical plan as necessary. In addition, the arrangement movement of the medical device is controlled based on the medical stage, the operation condition of the medical device is set, or the measurement value of the medical device is acquired.

  The console 25 is used to input various control commands to the surgery monitoring system 2, and a user interface device (not shown) such as a mouse, a trackball, a joystick, a keyboard, and various switches is used to input various control commands. ) Is arranged. In addition, touch information such as a touch panel formed on the monitor 241 as indicated by a dotted arrow is also included.

  The operation of the medical accident prevention system configured as described above will be specifically described with reference to the flowchart of FIG. In the present embodiment, description will be made assuming a malignant brain tumor removal operation.

  In step ST201, the state determination unit 22 acquires a surgical plan from the surgical planning unit 11. The surgical plans shown in FIGS. 3 to 5 are classified into medical stages, and are divided into, for example, four stages of “craniotomy”, “approach to tumor”, “image diagnosis”, and “closed wound”. However, this is a simplified classification for explanation, and a necessary medical stage such as an “anesthetic” stage may be added before “craniotomy”. In order to remove a plurality of tumors, “approach to tumor” and “imaging diagnosis” may be repeated. When the position of the medical staff or the position of the medical device largely changes, each medical stage may be further divided.

  In FIG. 3, the arrangement positions of all the medical staff (doctor A, doctor B, doctor C, nurse E, and nurse F) necessary for performing the operation are shown for each medical stage. Each medical staff is associated with an identifier that is uniquely identifiable to the doctor A, such as D001. When there is patient movement, the placement position is also written on the patient P.

  In FIG. 4, for each medical stage, the main medical equipment (image diagnostic apparatus, surgical microscope, instrument table, vital monitor, electroencephalogram monitor, anesthesia machine, nurse cart) necessary for performing the operation is shown. It is written. Further, the upper part of each column indicates the arrangement position, and the lower part describes the operating conditions of the medical device. In the diagnostic imaging apparatus, as in M001, each medical device is associated with an identifier that can be uniquely identified.

  FIG. 5 shows the start time, end time, and required time for each medical stage. For example, in the “opening” stage, the start time is 9:00, the end time is 10:00, and the required time is 60 minutes.

  In step ST202, based on the tables of FIGS. 3 and 4, the state determination unit 22 confirms whether the medical staff and the medical devices are in the correct arrangement at the start of the “craniotomy” stage.

  FIG. 7 is an example of arrangement of medical staff and medical devices in the operating room by the “craniotomy” stage. The operating room is divided into square grids. In the embodiment, an area occupied by substantially one person as viewed from above is one grid.

  One grid of the embodiment is commonly used for both medical staff and medical devices, but may be managed independently using a grid of a different size. Here, the position of the head for the medical staff and the center of the medical device as viewed from the upper part are the arrangement positions. That is, regarding the medical staff, doctor A (surgeon) is D3, doctor B (assistant doctor) is D2, doctor C (anesthesiologist) is F2, and nurse D is delivering surgical instruments on the instrument table. Located at F4. In addition, since nurse E mainly uses outer rotation (corresponding to various situations that occur in the operation), the arrangement is not set. However, a plurality of grids in a range in which outward rotation is performed may be specified.

  When the arrangement of medical staff and medical devices necessary for the “craniotomy” stage is confirmed, the “craniotomy” stage is started. At the stage of craniotomy, a surgeon (doctor A) and an auxiliary doctor (doctor B) attach a fixed frame to the head of the patient P, mark the craniotomy site, disinfect, cut the skin, cut bone, Work to lift the dura mater is done to secure the field.

  In step ST203, the placement monitoring unit 21 monitors the operation status information such as the placement of the medical staff and the medical device and the measured value of the medical device for each period determined as, for example, every minute. ·Record. The operation state information is sequentially sent to the state determination unit 22.

  In step ST204, the state determination unit 22 determines whether there is a difference between the actual medical staff and the arrangement of medical devices and the surgical plan. If there is a difference (step ST204: Yes), the difference is recorded in the history information storage unit 24 as a log. If the difference information is at a level that requires medical staff to be alerted, a warning message and a correct layout are presented to the monitor 241 via the display / device control unit 24 (step ST205). If there is no problem based on the judgment of the doctor, the medical practice may proceed as it is. If there is a problem, the medical procedure is rearranged to an appropriate position and the process returns to step ST203. Further, when a difference occurs, the video analysis unit 211 synchronizes with the time stamp of the video being recorded to facilitate subsequent verification.

  As shown in FIG. 4, operating conditions can be written in the medical device. For example, is the surgical microscope M002 in the retracted position? Is the heart rate detected by the vital monitor M004 within a specified range? Is the BIS value of the electroencephalogram monitor M005 within a specified range? And so on. Even if this condition is not satisfied, it is recorded as difference information in the history information storage unit 24. If this difference information is a level that requires medical staff to be alerted, a warning is given to the monitor 241 via the display / device control unit 24. Display a message. Moreover, you may call attention with an audio | voice.

  FIG. 6 is an example of a table showing difference information. For each medical stage, items, occurrence times, plan values, implementation values, etc. are recorded. Item No. 1 records that nurse D was absent at the start of the “opening” stage (9:00). Item number 2 indicates that the heart rate measured by the vital monitor M004 at 9:15 in the “craniotomy” stage exceeded the preset range (A1 or more and A2 or less) and was an A3 value. ing. Item No. 3 indicates that the BIS (bispectral index) value of the electroencephalogram monitor M005 exceeds the preset range (C1 or more and C2 or less) at 11:34 in the “approach to tumor” stage, It means that there was. In particular, when the heart rate or the BIS value changes suddenly compared to the planned value, it indicates that the patient's condition has changed suddenly, so an immediate alert message is required for the medical staff.

  In step ST206, it is determined whether all the medical steps have been completed. If all the medical steps are completed, the flowchart is ended, but when the “craniotomy” stage is completed (step ST206: No), the process proceeds to the next medical step, “approach to tumor” step, and step ST202. Now we will confirm the placement of the “Tumor Approach” stage start.

  The “approach to tumor” stage is an operation until the tumor part is exposed to the operative field while excluding and excising the brain tissue, and is performed under a surgical microscope. That is, the surgical microscope is moved to the position D2 according to the surgical plan of FIG. When the automatic movement mechanism is mounted on the surgical microscope, the display / device control unit 24 can automatically move the medical device from the retracted position to the used position. The subsequent steps are the same as the steps in the “head opening” stage, and are therefore omitted.

  Similarly, in the “image diagnosis” stage, the surgical microscope is temporarily retracted and the patient P is moved into the image diagnosis apparatus according to the operation plan of FIG. During image diagnosis, it is undefined except for doctor C (anesthesiologist). In addition, a predetermined scanning condition based on a surgical plan is automatically set for the diagnostic imaging apparatus.

  When it is confirmed by image diagnosis that the tumor has been removed, the closing operation is performed at the “closing” stage.

  As described above, according to the first embodiment, medical staff and medical devices can be managed based on a surgical plan, so that it can be performed based on a plan such as organizing, organizing, and cleaning an operating room during medical practice. . In addition, depending on the progress of medical practice and the occurrence of troubles, even if there is a deviation from the planned arrangement, instructions can be issued on the alert and on the monitor screen, so that the operation may change without maintaining safety. Can be prevented. For this reason, it is possible to prevent medical accidents. Also, in the case where the verification work is performed after the medical practice, since the time when the difference information is generated is indicated, there is an effect that it is possible to easily extract the video part having the post problem.

(Second Embodiment)
In this embodiment, an operation plan in the operation planning system 1 will be described. The operation plan analysis unit 13 can improve the reliability of the operation plan by referring to the past history in the history information storage unit 23 and performing feedback on the operation plan formulation in the operation plan unit 11.

  FIG. 10 is a flowchart of the operation planning. In formulating an operation plan for performing an operation, in step ST <b> 101, the operation plan analysis unit 13 acquires operation history information from the history information storage unit 23.

In step ST102, the surgical site is searched as a search word, and reference site data is extracted. Also, what kind of medical stage did many problems occur by performing various statistical processing on the difference information of the extracted data? Can be analyzed and displayed (step ST103), the optimal number of medical staff members, the number of medical devices, the required time, etc. can be obtained, and an operation plan can be formulated (step ST104). It is also possible to browse the video data of the part that caused the problem as needed.

  Therefore, according to the second embodiment, it is possible to improve the reliability of the operation plan by effectively feeding back the past history to the operation plan formulation.

(Third embodiment)
In the present embodiment, an embodiment of a floor grid panel that is effective for arrangement management of medical staff and medical devices will be described. FIG. 11 is a block diagram of the medical accident prevention system according to the present embodiment, and FIG. 12 is a block diagram of the floor grid panel.

  As shown in FIG. 12, the floor grid panel 110 has an RF-ID reception that reads an RFID tag attached to the medical staff or medical device, and a contact detection unit 111 that senses contact of the medical staff or medical device located above the floor grid panel 110. The unit 112 also includes a light emitting unit 113 that lights the position designation so as to be visible. The contact detection unit 111 can employ various methods such as a method of reading a change in magnetic field and a method of reading a resistance value change at a contact point, and the light emitting unit 113 is preferably an LED (Light Emitting Diodes).

  A plurality of floor grid panels (110 # 1 to 110 # N) are laid on the floor of the operating room, and a terminal 114 that bundles the wiring of the contact detection unit 111 of each grid panel 110 # 1 to #N, RF-ID reception. The terminal 115 in which the wiring of the unit 112 is bundled is connected to the arrangement monitoring unit 21. The terminal 116 in which the light emitting unit 113 is bundled is connected to the display / device control unit 24. The medical accident prevention system configured using the floor grid panel as described above can identify the medical staff and the medical equipment on the floor grid panel 110, and at the same time has a different arrangement from the surgical plan. An appropriate position can be designated by the light emitting unit 113.

(Other embodiments)
Also, by registering the voice of the medical staff in the voice recognition unit 213 of FIG. 1 or FIG. 11, the operation of the medical device can be controlled by the voice of the medical staff. Furthermore, by providing the video analysis unit 211 with a medical staff eye tracking function and a gesture determination function, it is possible to control the operation of the medical device by the medical staff eye and gesture.

  According to the embodiment described above, it is possible to provide a medical accident prevention system that guides medical staff and medical devices during medical practice to a place according to the arrangement plan, and facilitates verification after medical practice.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention.

  These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

1 ... Surgery planning system,
2… Surgery monitoring system,
11 ... Surgery Planning Department,
12 ... plan information storage part,
13 ... Surgery plan analysis department,
21: Arrangement monitoring unit,
22 ... state determination part,
23. History information storage unit,
24. Display / device control unit,
24 ... console,
110: Floor grid panel.

Claims (8)

A surgical planning department that develops placement plans for medical staff and / or medical equipment,
A placement monitor that obtains the actual placement of medical staff and / or medical equipment;
A state determination unit for obtaining difference information between the actual arrangement acquired by the arrangement monitoring unit and the arrangement plan;
Based on the difference information, a display / device control unit that displays information for guiding the medical staff and / or the medical device to a position based on the arrangement plan; and
A grid panel disposed on the floor and divided into grid shapes;
The arrangement monitoring unit obtains a grid on the grid panel representing the actual arrangement,
The display / apparatus control unit displays the information to be guided on a grid on the grid panel, which represents a position based on the arrangement plan.
Medical accident prevention system. The surgical planning unit divides the series of flows related to medical療行multiple medical stages, formulated medical staff or medical equipment, or the placement plan both for each of the medical stage,
The placement monitoring unit obtains an actual placement of medical staff and / or medical devices during medical practice;
The medical accident prevention system according to claim 1.   2. The medical accident prevention system according to claim 1, wherein the display / device control unit displays, on a monitor, a message for alerting a doctor staff member during medical practice and the arrangement plan based on the difference information. The display and the device control unit, the medical accident prevention system according to claim 1, wherein to control the placement movement of the medical device based on the medical stage. The display and the device control unit, setting the operating conditions of the medical device based on the medical stage, the medical accident prevention system according to claim 1, wherein performing the acquisition of the measured values.   The arrangement monitoring unit includes a video analysis unit that analyzes the arrangement of medical staff and medical devices during medical practice, an individual identification unit that uniquely identifies the medical staff and medical devices, and a voice recognition unit that recognizes the voice of the medical staff The medical accident prevention system according to claim 1.   The medical accident prevention system according to claim 1, further comprising: a history information storage unit that stores the difference information; and a plan analysis unit that analyzes an optimal arrangement plan for a medical practice from the history of the history information storage unit.   The medical system according to claim 1, wherein the grid panel has a light emission source that uniquely identifies the medical staff and / or medical devices existing on the panel and that can visually recognize a grid that represents a position based on the arrangement plan. Accident prevention system.

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