WO2006057336A1

WO2006057336A1 - Medical process quality management system and medical process quality management method

Info

Publication number: WO2006057336A1
Application number: PCT/JP2005/021673
Authority: WO
Inventors: Yoshinori Iizuka; Satoko Tsuru; Masahiko Munechika
Original assignee: Yoshinori Iizuka; Satoko Tsuru; Masahiko Munechika
Priority date: 2004-11-25
Filing date: 2005-11-25
Publication date: 2006-06-01
Also published as: JPWO2006057336A1; JP5188067B2

Abstract

A medical process quality management system (10) includes: a medical process database (18) for storing a plurality of medical processes to be executed on a patient; a current process database (20) for storing a medical process in which the patient is present; a patient state input unit for receiving input of the patient state; s process management unit (24) for judging whether the patient state inputted by the patient state input unit (14) has reached the target state of the current process and reading out the next medical process to be executed as the next process from the medical process storage unit (18) when the patient state is judged to have reached the target state; a next process candidate output unit (26) for outputting the next process read out by the process management unit (24) as a candidate of the next medical process to be executed; and a next process input unit (12) for receiving input of the next medical process to be executed and writing it into the current process storage unit. This guarantees the medical quality by flexibly handling the patients individually.

Description

Medical process quality management system, medical process quality management method

Technical field

[0001] The present invention relates to a system for managing the quality of a medical process performed on a patient.

[0002] Traditionally, the critical path (also called the Talical Path or Care Map) has been known as a tool for systematic assurance and improvement of medical quality and efficiency. The critical path in medical care refers to the planning of care for other occupations' care, the vertical axis (row) indicating the area of care (examination, treatment, patient family education, etc.), time (day, treatment phase). Etc.) with a horizontal axis (column). This has the advantage that the medical-related actions over one patient, other occupations, and other fields are easily mapped. The Taltical Path aims to ensure and improve the quality and efficiency of medical care through the standardization and visualization of medical planning and implementation, that is, to save time and medical resources. In addition, it is expected that team medical care will be promoted through the process of creating and revising the critical path. In addition, it serves as a tool for disclosing process information to in-house and out-of-hospital medical professionals, patients and consumers.

[0003] For the critical path, for example, “Critical 'Path and Hospital Management” (Toshihiko Hasegawa, Yakuho Hokpo Co., Ltd., November 10, 1998), page 13-21, “Medical records change! 7-18, “Decisive Edition Tali-Cal Pass” (Hidehisa Soejima et al., Medical School, April 15, 2004), “Recent Progress of Critical Path 2004” (Shinichiro Takeda, Jiho Co., Ltd., June 2004) It is described in detail on pages 27-34 of 20th).

Disclosure of the invention

Problems to be solved by the invention

[0004] Although the critical path has multiple advantages as described above, the critical path is used for patients, patients with underlying illnesses, patients with a high risk of complications, etc. who cannot be diagnosed. Often not applicable. Even if the critical path can be applied, There may be cases where the critical path is deviated in the middle of the expected standard course. In this way, the application rate of critical paths is low!

[0005] In view of the above background, an object of the present invention is to provide a medical process quality management system that can flexibly cope with the individuality of a patient and guarantee the medical quality.

Means for solving the problem

[0006] The medical process quality management system of the present invention stores a plurality of medical processes to be performed on a patient, a target state to be achieved in each medical process, and an execution order of each medical process. A storage unit; a current process storage unit that stores a medical process in which the patient is currently stored among the medical processes stored in the medical process storage unit as a current process; and a patient state that receives input of a patient state It is determined whether the patient state input by the input unit and the patient state input unit has reached the target state of the current process, and when it is determined that the patient state has reached the target state, the medical treatment is performed. The process management unit that reads the next medical process to be executed from the process storage unit as the next process, and the next process read by the process management unit are executed next. And an output unit for outputting as the candidate of the medical process, then Installing receives the medical process for implementing, the following process input unit for writing the current process storage unit for.

[0007] In the medical process quality management system, the execution order stored in the medical process storage unit includes a branch according to a patient state, and the process management unit determines that the patient state has reached a target state. If determined, the medical process storage unit may read the next process corresponding to the patient state input by the patient state input unit.

[0008] The medical process quality management system includes a history storage unit that stores an input history of a medical process input to the next process input unit, and is based on an input history stored in the history storage unit. The execution order of each medical process may be determined, and the determined execution order may be stored in the medical process storage unit.

[0009] In the medical process quality management system, the medical process storage unit stores a transition state of a patient assumed during a transition from an initial state to a target state in each medical process, The management unit is the patient status input unit It is possible to judge whether or not the input patient state is different from the assumed patient transition state, and output a warning when it is judged that the patient state is different from the assumed patient transition state. .

[0010] In the medical process quality management system, the medical process storage unit stores a treatment to be performed on a patient in each medical process, and the process management unit stores the current process in the current process. The treatment may be read from the medical process storage unit, and the output unit may output the treatment read by the process management unit.

[0011] In the medical process quality management system, the medical process storage unit stores a treatment to be performed on the patient in association with a patient state, and the process management unit stores the treatment in the patient state input unit. The treatment corresponding to the patient state inputted in this manner may be read from the medical process storage unit.

[0012] In the medical process quality management system, the medical process storage unit stores a treatment to be performed on a patient in association with a schedule for performing the treatment, and the process management unit is based on the schedule. Thus, the treatment to be performed may be read from the medical process storage unit.

[0013] The medical process quality management system includes an implementation treatment input unit that inputs a treatment performed on a patient, and the process management unit uses the treatment input by the implementation treatment input unit as an implemented treatment. You may write in the said medical process memory | storage part.

[0014] In the medical process quality management system, the process management unit reads out a treatment to be performed in a current process from the medical process storage unit, and reads out a treatment performed in a current process from the current process storage unit, The output unit may output a treatment to be performed in the current process and an implementation status thereof.

[0015] The medical process quality management method of the present invention stores a plurality of medical processes to be performed on a patient, a target state to be achieved in each medical process, and an execution order of each medical process. Using a medical process quality management system comprising a storage unit and a current process storage unit that stores a medical process in which a patient is currently placed among the medical processes stored in the medical process storage unit as a current process, A method for managing the quality of the medical process, which accepts patient status input In the input step and the patient status input step, it is determined whether or not the patient status input has reached the target status of the current process, and it is determined that the patient status has reached the target status A process management step for reading a medical process to be executed next as a next process, and an output step for outputting the next process read in the process management step as a candidate for the next medical process to be executed. A next process input step for receiving an input of a medical process to be executed next and writing it in the current process storage unit.

[0016] As described below, there are other aspects of the present invention. Accordingly, the disclosure of the present invention is intended to provide some aspects of the invention and is intended to limit the scope of the invention described and claimed herein.

Brief Description of Drawings

FIG. 1 is a diagram showing a configuration of a medical process quality management system according to the present embodiment.

FIG. 2 is a diagram showing an example of a medical process database.

FIG. 3 is a diagram showing an example of a medical process database.

FIG. 4 is a diagram for explaining a transition state in a medical process.

FIG. 5 is a diagram showing an example of a current process database.

FIG. 6 is a flowchart showing the operation of the medical process quality management system of the present embodiment.

FIG. 7 shows an actual clinical process chart.

FIG. 8 is a diagram showing an actual unit migration logic table.

FIG. 9 is a diagram showing an actual unit target state table.

FIG. 10 is a diagram showing an actual unit sheet.

FIG. 11 is a diagram showing a modification of the current process database.

BEST MODE FOR CARRYING OUT THE INVENTION

[0018] The following is a detailed description of the invention. However, the following detailed description and the accompanying drawings do not limit the invention. The scope of the invention is defined by the appended claims.

[0019] The medical process quality management system according to the present embodiment includes a plurality of medical doctors to be performed on a patient. The medical process storage unit that stores the treatment process, the target state to be achieved in each medical process, and the order of execution of each medical process, and the patient is currently out of the medical processes stored in the medical process storage unit A current process storage unit that stores the current medical process as a current process, a patient state input unit that accepts input of the patient state, and the force at which the patient state input in the patient state input unit has reached the target state of the current process If it is determined that the patient state has reached the target state, the medical process storage unit reads the next medical process to be executed as the next process and the process management unit reads it. The output unit that outputs the next processed process as a candidate for the next medical process and the input of the next medical process , And a next process input unit that writes the current process storage unit.

As described above, the medical process storage unit stores the target state to be achieved in each medical process and the execution order of each medical process. Then, the medical process in which the patient is currently stored is stored in the current process storage unit as the current process, and it is determined that the patient state input from the patient state input unit has reached the target state of the current process. Sometimes it moves from one medical process to the next. This ensures that each medical process can be executed and the quality of care can be managed. In addition, when the patient state reaches the target state, the next medical process to be performed is read out from the medical process storage unit storing the execution order and output, thereby grasping the next medical process to be performed. be able to. In addition, with the configuration in which the next medical process to be performed is determined based on the next process information input to the next process input unit, the determination of the medical process to be performed is left to a doctor who is qualified to perform the medical practice. So you can guarantee the quality of medical care. The medical process input to the next process input unit is not limited to the next process candidate output from the output unit. It is also possible to move to a medical process other than the medical process output as a candidate.

[0021] In the medical process quality management system, the execution order stored in the medical process storage unit includes a branch corresponding to the patient state, and the process management unit determines that the patient state has reached the target state. When the determination is made, the next process corresponding to the patient state input by the patient state input unit may be read out from the medical process storage unit. [0022] As described above, the execution order of the medical process includes a branch corresponding to the patient state, so that the individuality of the patient can be dealt with. In the conventional critical path, the standard medical process was limited, so there was a problem that the critical path could not be applied to patients who also deviated from the critical nose force and the medical process could not be managed. According to this embodiment, the medical process to be performed next can be changed according to the patient's condition, so the quality of the medical process for various patients with different age, gender, medical history, etc. can be managed. Can do.

[0023] The medical process quality management system includes a history storage unit that stores an input history of a medical process input to the next process input unit, and each medical process based on the input history stored in the history storage unit. The execution order of the processes may be determined, and the determined execution order may be stored in the medical process storage unit.

[0024] By storing the input history of the medical process input to the next process input unit in this way and determining the execution order of the medical process based on the input history, it can be applied to more patients. It can be updated to the execution order of the medical process. In other words, the order in which medical processes are performed varies depending on the age, gender, medical history, etc. of the patient, and the medical process changes as medical progress progresses. According to the present embodiment, based on the information on the actually selected medical process, for example, a branch to a medical process that is less frequently transferred is deleted, and a branch to a medical process that is frequently transferred is added. Can do. As a result, the medical process storage unit can store the execution order of medical processes applicable to more patients.

[0025] In the medical process quality management system, the medical process storage unit stores a transition state of the patient assumed during the transition from the initial state to the target state in each medical process. It is determined whether the patient state input from the state input unit is different from the assumed patient transition state, and a warning is issued if it is determined that the patient state is different from the assumed patient transition state. It may be output.

[0026] By outputting a warning when the patient's state deviates from the assumed transition state in this way, it is possible to take an early response when the patient becomes a state not assumed in the medical process, Manage the quality of medical care. This check mechanism also assumes patient status. The quality of medical care can be managed by encouraging medical staff to promptly intervene to constantly control the transition state.

[0027] In the medical process quality management system, the medical process storage unit stores the treatment to be performed on the patient in each medical process, and the process management unit stores the treatment in the current process. The force may also be read, and the output unit may output the treatment read by the process management unit.

[0028] By reading and outputting the treatment to be performed stored in the medical process storage unit in this way, it is possible to grasp the treatment to be performed in the medical process.

[0029] In the medical process quality management system, the medical process storage unit stores the treatment to be performed on the patient in association with the patient state, and the process management unit stores the patient state input in the patient state input unit. Read the treatment corresponding to the medical process memory.

[0030] By reading out and outputting the treatment corresponding to the patient state from the medical process storage unit in this way, it is possible to perform an appropriate treatment according to a change in the patient state.

[0031] In the medical process quality management system, the medical process storage unit stores the treatment to be performed on the patient in association with the schedule for performing the treatment, and the process management unit executes the treatment based on the schedule. The treatment to be performed may be read from the medical process storage unit.

By outputting the treatment to be performed on the patient based on the schedule in this way, for example, only the treatment to be performed on the day can be output, so that the treatment to be performed can be easily understood.

[0033] The medical process quality management system includes an implementation treatment input unit for inputting a treatment performed on a patient, and the process management unit stores the treatment input in the implementation treatment input unit as a completed treatment. You may write in the part.

[0034] With such a configuration, it is possible to avoid performing an already implemented procedure in duplicate by updating the status of the implemented procedure to implemented.

[0035] In the medical process quality management system, the process management unit reads out the treatment to be performed in the current process from the medical process storage unit and has already performed in the current process. The current process memory capacity may also be read out, and the output unit may output the process to be performed in the current process and its implementation status.

[0036] By outputting the treatment to be performed in the current medical process and the implementation status in this way, it is possible to contribute to medical quality management. In other words, by making it easy to understand the actions taken by other nurses and doctors, it is possible to prevent the implementation of duplicate actions, promote the reliable implementation of actions to be taken, and manage the quality of the medical process. it can.

[0037] The medical process quality management method of the present embodiment stores a plurality of medical processes to be performed on a patient, a target state to be achieved in each medical process, and an execution order of each medical process. A medical process quality management system including a storage unit and a current process storage unit that stores, as a current process, a medical process in which a patient is currently stored among the medical processes stored in the medical process storage unit. This is a method for managing the quality of the treatment process, which is a patient status input step that accepts input of the patient status, and whether the patient status input in the patient status input step has reached the target status of the current process. If it is determined that the patient state has reached the target state, the medical process memory is stored in the next process. And process management step of reading as vinegar,

And an output step for outputting the next process read out as a candidate for the next medical process to be executed, and a next process input step for receiving an input of the next medical process to be executed and writing it in the current process storage unit.

[0038] With this configuration, similarly to the medical process quality management system of the present embodiment, there is an effect that each medical process can be reliably performed and the medical quality can be managed. Various configurations of the medical process quality management system of the present embodiment can also be applied to the medical process quality management method of the present embodiment.

Hereinafter, a medical process quality management system according to an embodiment of the present invention will be described with reference to the drawings.

FIG. 1 is a diagram showing a medical process quality management system 10 according to the embodiment. The medical process quality management system 10 includes a next process input unit 12 for inputting a medical process to be executed next, a patient state input unit 14 for inputting a patient state, and information on the medical process. Medical process database 18 stored, process management unit 24 that manages medical processes based on information stored in medical process database 18, and current medical process information stored by the patient A process database 20 is provided. Based on the current medical process information stored in the current process database 20, the process management unit 24 outputs an instruction for the treatment to be performed on the patient, the implementation status of the treatment, and a candidate for the next medical process.

[0041] The medical process quality management system 10 of the present embodiment is configured by a normal personal computer equipped with a keyboard and a display. In addition, a portable terminal equipped with input means such as the next process input unit 12 and patient condition input unit 14 and output means such as the next process candidate output unit 26, instruction output unit 28, and treatment status output unit 30 is prepared, and the process A configuration may be adopted in which a server having the function of the process management unit 24 that performs management is connected via a network.

Next, each configuration of the medical process quality management system 10 according to the embodiment will be described.

The medical process database 18 is a database for storing information on medical processes for medical treatment for diseases. A medical process is a process envisioned in a clinical setting for a disease. The medical process is sized appropriately to manage the quality of medical practice.

FIGS. 2 to 4 are diagrams showing examples of data stored in the medical process database 18. Figure 2 shows an example of a medical process for ischemic heart disease. As shown in FIG. 2, the medical process database 18 stores medical processes for diseases and the execution order of the medical processes. This execution order is created based on interviews from actual clinical sites. In the example shown in FIG. 2, the medical processes P001 to P008 from the description of cardiac catheterization to the discharge are described along with the order of implementation! After the PCAT hospitalization process P002, there are two types of processes P003 and P008 depending on the patient's condition. In addition, after the process of cardiovascular follow-up P005, it branches into two types of processes P006 and P007 depending on the patient's condition! As described above, since the execution order of the medical process database according to the present embodiment has a branch according to the patient's condition, it is possible to reduce the possibility that a predetermined medical process force deviates. Therefore, the medical process stored in the medical process database 18 can be applied to patients having various personalities, and the quality of medical care can be controlled. Can

FIG. 3 is a diagram showing an example of data that the medical process database 18 has for each medical process. As shown in Figure 3, the medical process database 18 contains a “process ID” that identifies each process, a “procedure” to be performed in that medical process, a “initial state” of the patient in that medical process, The information includes the “target state” of the patient, the “transition state” assumed when moving from the initial state to the target state, and the “next process” indicating the process to be performed next.

[0045] There are two types of "treatment": treatment that is unconditionally performed in the medical process, and conditional treatment that is performed according to the patient's condition. In the case of a treatment that should be performed unconditionally in the medical process, the condition is “none”, and in the case of a treatment performed according to the patient's condition, the condition for performing the treatment is stored as “condition”. Has been. For example, in process POO 2, procedure TOO 1 is an unconditionally performed procedure. In the case of such a treatment, a schedule of the execution date and time of the treatment may be associated and stored. The schedule is, for example, information on the day of the medical process, or information on the time of implementation. In process P002, treatment T0034 is performed when the patient complains of pain, and treatment T056 is performed when blood pressure is high. The “next process” information corresponds to the execution order information shown in FIG. When the execution order information shown in Fig. 2 changes, the contents of the "next process" in each process are also changed.

[0046] FIG. 4 is a diagram illustrating a transition state assumed when moving from the initial state to the target state. In FIG. 4, the vertical axis represents the patient's condition and the horizontal axis represents time. It is considered that the state that tends from the initial state (ST04) to the target state (ST08) approaches the target state with time due to the transition shown in graph L1. However, the actual patient state may reach the target state at a faster pace than can be expressed by a straight line (Graph L2) or may slowly reach the target state (Graph L3). Accordingly, the assumed transition state Str is represented by a region having the graph L2 as the upper limit and the graph L3 as the lower limit. If the patient's state is included in this transition state Str, it can be determined that the medical process is proceeding smoothly. For example, when an unexpected complication occurs, the patient's state does not move toward the target state, but is different from the assumed transition state. Transition state St where patient state is assumed St If it is out of r, a warning is output from the warning output unit 32. This allows early determination that the selected medical process is not appropriate.

FIG. 5 is a diagram showing an example of data currently stored in the process database 20. The current process database 20 basically stores the same type of data as the data stored in the medical process database 18. Currently, the process database 20 stores a “patient ID” that identifies a patient and a “status” that indicates the implementation status of the treatment, in addition to the data stored in the medical process database 18. The same information as the medical process database 18 is read out from the medical process database 18 by the process management unit 24 and stored in the current process database 20. With this configuration, it is not necessary to access the medical process database 18 every time in order to obtain information about medical processes such as treatments to be performed in the current process. Although not shown in FIG. 5, the current process database 20 may store the patient status input from the patient status input unit 14.

[0048] In the present embodiment, the current process database 20 employs a configuration that can be added to an executed procedure when it is stored and the procedure is performed. In the actual medical field! In some cases, it may be necessary for the medical process! In such a case, the executed actions can be grasped by adding the executed actions to the current process database 20 and storing them. In addition, by accumulating a history of treatments that have not been envisaged, treatment items to be implemented in each medical process can be updated. For example, frequently performed treatments that are not envisaged can be added as possible treatments.

[0049] Returning to FIG. 1, the description of the configuration of the medical process quality management system 10 will be continued. The next process input unit 12 has a function of accepting an input of the next medical process to be transferred when the currently executed medical process is completed. The input of the medical process is performed by a doctor who is qualified to perform the medical practice. Information on the medical process input from the next process input unit 12 is stored in the input history file 22. Based on the data in the input history file 22, it is possible to analyze which medical process has been shifted from which medical process to determine the execution order of each medical process actually performed. And by analysis The obtained execution order can be reflected in the medical process database 18. For example, even if a medical process is rarely registered as the next process, it can be newly registered as the next process if the frequency of transition is high. As a result, a medical process flow that has been exceptional can be registered as a normal medical process flow, and can be output as a candidate for the next process.

[0050] The patient state input unit 14 has a function of receiving an input of a patient state. The patient's state is input by, for example, a nurse or doctor who visits the patient regularly and conducts an inquiry. The patient state input unit 14 may accept examination result data output from an examination system (not shown) as input data. The execution treatment input unit 16 has a function of receiving input of the content of treatment performed on the patient.

[0051] The process management unit 24 has a function of managing a medical process according to a patient's condition. The process management unit 24 first reads information on the medical process in which the patient is currently located from the medical process database 18 and stores the information in the current process database 20. The medical process in which the patient is currently located is specified by the medical process input from the next process input unit 12. The process management unit 24 monitors whether or not the medical process can be transferred to the next medical process, and outputs a treatment to the patient based on the medical process information currently stored in the process database 20. Hereinafter, the process management function of the process management unit 24 will be described in detail.

[0052] The process management unit 24 receives the patient state information from the patient state input unit 14, compares the received patient state with the target state of the medical process currently stored in the process database 20, and It has a function to determine whether or not the force of the state has reached the target state. When it is determined that the patient's condition has reached the target condition, the end of the medical process is notified and the transition to the next process is encouraged. At this time, the process management unit 24 reads information on the next process from the current process database 20 and outputs it as a next process candidate from the next process candidate output unit 26. Further, the process management unit 24 has a function of determining whether or not the patient state is different from the transition state in the medical process when the patient state is not the target state. If it is determined that the current state is different from the transition state, a warning is output from the warning output unit 32 to prompt the transition to the next process. The process management unit 24 has a function of reading a treatment to be performed in the medical process from the current process database 20 and outputting the read treatment from the instruction output unit 28. In the case of a conditional treatment stored in association with the patient state, the process management unit 24 reads the treatment corresponding to the patient state input from the patient state input unit 14 and gives an instruction. Output from output unit 28.

Furthermore, the process management unit 24 updates the status of the treatment currently stored in the process database 20 based on the information on the implementation status of the treatment input from the implementation treatment input unit 16. In addition, the process management unit 24 outputs the status of treatment implementation from the treatment status output unit 30 in response to a request from the user.

[0055] As shown in FIG. 1, the medical process quality management system 10 includes a medical record database 36 that collectively manages a history of patient status information, and patient status information and patient data that are currently input to the process database 20. A patient state history management unit 34 that reads out the treatment performed on the patient and writes it in the medical record database 36 may be provided. If such a configuration is adopted, the patient state input to the patient state input unit 14 of the medical process quality management system 10 is automatically accumulated and a patient chart is created.

FIG. 6 is a flowchart showing the operation of the medical process quality management system 10 of the present embodiment. With reference to FIG. 6, the operation of the medical process quality management system 10 of the present embodiment will be described.

[0057] The medical process quality management system 10 first receives an input of a medical process performed on a patient (S10). The process management unit 24 reads the medical process input from the next process input unit 12 from the medical process database 18 and stores it in the current process database 20.

Next, the patient state input unit 14 of the medical process quality management system 10 receives the input of the patient state (S12). The process management unit 24 compares the input patient state with the target state of the current medical process stored in the current process database 20 to determine whether or not the patient's state has reached the target state. Determine (S14). If it is determined that the patient's condition has reached the target, the process management unit 24 reads information on the next process from the current process database 20 (S16). At this time, multiple If the next process information is stored, the process management unit 24 may read one piece of next process information corresponding to the patient's condition, or a plurality of next processes in the order corresponding to the patient's condition. The information may be read out. The process management unit 24 passes the read next process information to the next process candidate output unit 26, and the next process candidate output unit 26 outputs the next process information passed from the process management unit 24 (S18). Thereafter, the medical process quality management system 10 proceeds to processing (S10) for receiving an input of the next medical process.

Next, the operation when it is determined that the input patient state has not reached the target state will be described. If it is determined that the input patient state does not reach the target state (NO in S14), the process management unit 24 determines whether the patient state is not deviated from the transition state. (S20). As a result of this determination, if it is determined that the patient's state is different from the transition state, the process management unit 24 outputs a warning from the warning output unit 32. This makes it possible to respond quickly when the patient's condition deviates from the condition predicted in the current medical process. If it is determined that the patient's state has not deviated from the transition state (NO in S20), the process management unit 24 reads the treatment to be performed on the patient from the current process database 20, and reads the Information is output from the treatment status output unit 30 (S24). Thereafter, the medical process quality management system 10 returns to the process (S12) for accepting the input of the patient state. If there is no treatment to be performed on the patient, the process returns to the process of accepting the patient state (S12) without outputting the treatment.

The configuration and operation of the medical process quality management system 10 according to the present embodiment have been described above.

The medical process quality management system 10 according to the present embodiment stores the medical process execution order and the target state of each medical process in the medical process database 18. Then, the next process information input from the next process input unit 12 is read out and stored in the current process database 20, and the medical process information stored in the current process database 20 and the patient input from the patient state input unit 14 are stored. Since the process management unit 24 manages the medical process based on the state of the medical process, the quality of the medical process can be managed. sand In other words, the transition to the next medical process is made only after the patient's state reaches the target state of each medical process, so that each medical process can be reliably performed.

In the medical process quality management system 10 according to the present embodiment, the medical process database 18 stores the execution order of each medical process. When the patient state reaches the target state, the process management unit 24 outputs the next process information read from the medical process database 18 as a next process candidate. As a result, the user can easily grasp the medical process to be performed next.

[0062] The medical process quality management system 10 according to the present embodiment outputs the treatment to be performed on the patient and the implementation status, so that it is easy to determine whether or not the power in each medical process has been reliably implemented. I can grasp it. Thereby, the quality of medical care can be managed.

[0063] The medical process quality management system 10 of the present embodiment stores the information of the next process input from the next process input unit 12 in the input history file 22 as an input history. Based on the input history stored in the input history file 22, the data in the medical process database 18 is updated to the execution order suitable for more patients by reconstructing the execution order of each medical process. can do.

Next, an example of a medical process stored in the medical process database 18 is shown. FIG. 7 to FIG. 10 are diagrams showing a medical process for radical prostatectomy. This content is described in detail in the “Patient Condition Adaptation Path [Case Study 2005 Edition]” (supervised by Yasutsu Iizuka, Masahiko Munechika, Junko Minoru, edited by Patient Condition Adaptation Path System Study Group, Japanese Standards Association). Yes.

[0065] FIG. 7 is a diagram showing an overall execution order of medical processes that should be managed by radical prostatectomy. In this way, by memorizing the execution order of medical processes, it is possible to provide an overview of the entire medical process that should be managed by gradual prostatectomy.

FIG. 8 is a unit transition logic table that defines the transition logic when transitioning from each medical process shown in FIG. 7 to another medical process. By having unit transfer logic, it is possible to shift to a medical process according to the patient's condition. FIG. 9 is a unit target state table that shows unit transition conditions in the unit transition logic shown in FIG. 8 using objective criteria. By having such objective criteria, medical process quality management system Will be able to manage the medical process.

[0067] FIG. 10 is a unit sheet showing treatments, target states, and the like to be performed in each unit.

By storing specific treatments to be performed by each unit in this way, it is possible to reliably carry out treatments to be performed in the medical process.

[0068] Forces that illustrate specific examples of medical processes in FIGS. 7-10 Special attention should be paid to the following points. In other words, as described at the beginning of the Patient Condition Adaptation Path [Case Study 2005 Edition], the medical community relies on the personal abilities and motivation of excellent doctors, nurses, and pharmacists. The concept of quality management was sparse. The conventional critical path only shows a standard medical process, and what to do when it deviates depends on the ability of the individual physician. In other words, medical process management as shown in Fig. 7 to Fig. 10 that shifts to a medical process that suits the individual conditions of patients with diverse personalities guarantees the quality of medical care, and in fact, it is a fact that It was a new idea for the medical community.

As described above, the medical process quality management system of the present invention has been described in detail with reference to the embodiment. The present invention is not limited to the above-described embodiment.

[0070] In the above-described embodiment, the execution order information is read from the medical process database 18 and stored in the current process database 20, and when the patient state reaches the target state, the execution order is read from the current process database 20. As the execution order information, information corresponding to the current medical process may be read from the medical process database 18.

[0071] In the present embodiment described above, the flow of medical process transition (S14 to S22) and the flow of treatment for patient (S24) described in the same flowchart are the flow of medical process transition and the flow for patient The treatment flow may be operated independently. As a result, regardless of whether or not the patient status is input (S12), the instruction S for the treatment to be performed on the patient is made.

[0072] In the above-described embodiment, the process management unit 24 may read the patient's past history from the medical record database 36 and use it to determine the condition of the treatment to be performed on the patient.

[0073] In the above-described embodiment, the medical process quality management system 10 includes the chart data Forces Explaining the Configuration Including the Base 36 The medical process quality management system 10 may adopt a configuration in which it is connected to other electronic medical record systems via a network.

[0074] The medical process quality management system 10 of the above-described embodiment can also be used as a medical process simulation teaching material for students aiming at medical care, new medical professionals, or general medical professionals. In this case, a virtual chart is created and stored in the chart database 36, and a virtual patient state is input. As a result, candidates for the next process, treatments to be performed, and the like are output, so it is possible to learn how the medical process shifts and what treatment should be performed in each medical process.

[0075] In the above-described embodiment, a medical process applied to a patient having symptoms of only ischemic heart disease has been described as an example. However, in actuality, a case where treatment of a plurality of diseases is required or a combination is required. In some cases, multiple medical practices are required. As shown in Figure 11, information on concurrent processes being processed in parallel! / May be included in the current process database 20.

[0076] For example, the information of the current process database 20 shown in FIG. 11 is displayed on the screen, and when the process ID of the parallel process is selected, an interface for switching to the screen displaying the information of the process is provided. Therefore, it is possible to easily know the medical practice being performed on the patient in other clinical departments. This makes it possible to grasp the treatments and prescription drugs that have been performed in each of the multiple medical processes, prevent the repeated administration of powerful drugs, and select the best medical practice for the patient. .

[0077] In addition, for example, anesthesia in surgery and post-operative course treatment are performed in substantially the same procedure regardless of the type of disease. In this way, it is possible to create a library of medical activities common to various cases and prepare them separately from the process for each case. This saves the trouble of designing the same process in each case, and is convenient because the process does not need to be updated for each case when a common process changes due to the appearance of a new drug or the like.

[0078] As described above, the force explaining the preferred embodiment of the present invention considered at the present time. It will be understood that various modifications can be made to the present embodiment. The appended claims cover all modifications that fall within the true spirit and scope of the present invention. Industrial applicability

As described above, according to the present invention, each medical process can be surely performed and the quality of medical care can be managed, and the system can be useful as a system for managing the quality of medical processes performed on patients. It is.

Claims

The scope of the claims

[1] A medical process storage unit that stores a plurality of medical processes to be performed on a patient, a target state to be achieved in each medical process, and an execution order of each medical process;

A current process storage unit that stores, as a current process, a medical process in which a patient is currently located among the medical processes stored in the medical process storage unit;

A patient state input unit for receiving an input of a patient state;

It is determined whether or not the patient state input at the patient state input unit has reached the target state of the current process, and when it is determined that the patient state has reached the target state, the medical process storage unit A process management unit that reads out the next medical process as the next process;

An output unit that outputs the next process read out by the process management unit as a candidate for a medical process to be executed next;

A next process input unit that receives an input of a medical process to be executed next and writes the current process in the current process storage unit;

A medical process quality management system comprising:

[2] The execution order stored in the medical process storage unit includes a branch according to the patient state,

When it is determined that the patient state has reached a target state, the process management unit reads a next process corresponding to the patient state input by the patient state input unit from the medical process storage unit. The medical process quality management system according to claim 1.

[3] a history storage unit for storing an input history of the medical process input to the next process input unit;

2. The execution order of each medical process is determined based on the input history stored in the history storage unit, and the determined execution order is stored in the medical process storage unit. Or a medical process quality management system as described in 2.

[4] The medical process storage unit sets the target from the initial state in each medical process. The transition state of the assumed patient is stored during the transition to the state, and the process management unit determines whether the patient state input by the patient state input unit and the assumed patient transition state are present. Judge whether different forces,

2. The medical process quality management system according to claim 1, wherein a warning is output when it is determined that the patient state is different from an assumed transition state of the patient.

[5] The medical process storage unit stores a treatment to be performed on a patient in each medical process,

The process management unit reads the treatment in the current process from the medical process storage unit,

The medical process quality management system according to claim 1, wherein the output unit outputs the treatment read by the process management unit.

[6] The medical process storage unit stores a treatment to be performed on the patient in association with a patient condition,

6. The medical process quality management system according to claim 5, wherein the process management unit reads out the treatment corresponding to the patient state input by the patient state input unit from the medical process storage unit.

[7] The medical process storage unit stores a treatment to be performed on a patient in association with a schedule for performing the treatment,

6. The medical process quality management system according to claim 5, wherein the process management unit reads out a treatment to be performed from the medical process storage unit based on the schedule.

[8] Provided with a treatment input unit for inputting treatment performed on the patient,

6. The medical process quality management system according to claim 5, wherein the process management unit writes the treatment input by the implementation treatment input unit as an implemented treatment in the current process storage unit.

[9] The process management unit reads out the treatment to be performed in the current process from the medical process storage unit, and reads out the treatment performed in the current process in the current process storage unit. 9. The medical process quality management system according to claim 8, wherein the output unit outputs a treatment to be performed in a current process and an implementation status thereof.

A medical process storage unit storing a plurality of medical processes to be performed on a patient, a target state to be achieved in each medical process, and an execution order of each medical process, and stored in the medical process storage unit This is a method for managing the quality of a medical process by using a medical process quality management system including a current process storage unit that stores a medical process as a current process. And

A patient status input step for receiving an input of the patient status;

In the patient state input step, it is determined whether or not the input patient state has reached the target state of the current process, and when it is determined that the patient state has reached the target state, the medical process described above is performed. A process management step for reading out the next medical process to be executed as a next process from the storage unit;

An output step of outputting the next process read out in the process management step as a candidate for a medical process to be executed next;

A next process input step for receiving an input of a medical process to be executed next and storing it in the current process storage unit;

A medical process quality management method comprising: