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Development of Medical HAZOP (hazard and operability studies)-An effective educational approach of medical safety management

医疗HAZOP（危险和可操作性研究）的发展-医疗安全管理的有效教育方法

基本信息

批准号：
17590449
负责人：
OKAWA Atsushi
金额：
$ 2.18万
依托单位：
Tokyo Medical and Dental University, Graduate School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

项目摘要

Although a number of incident reports are collected in a hospital to improve patient safety management, it is difficult to eliminate all medical errors. An educational approach is essential to promote a strong consciousness of patient safety especially in a resident.Hazard And Operability Studies (HAZOP) is one of risk analysis methods having developed in a process industry such as chemical plants in 1970's. HAZOP is constituted by three steps, analyzing an operation in a step-wise fashion (called Work Breakdown Structure), discussing error causes and consequences, and mapping them onto a risk matrix. A main character of HAZOP differed from FMEA (Failure Mode and Effect Analysis) is that a discussion is proceeded in accordance with guide words, which enables to cover all the possibilities.To develop HAZOP as a new educational approach of medical safety management, we had a lot of group works with residents, orthopedic doctors, nurses, and co-medical staffs in a trial basis. The themes for residents were tracheal intubation, epidural tubing, and central venous catheterization ; the themes for medical doctors endoscopic lumbar disc surgery and total hip replacement ; the themes for co-medical staffs accidental fall of in-patients and management of prescriptions.Most of participants evaluated HAZOP as an effective training method for medical safety management. An issue to be solved was taking too much time for a session, and we plan to develop computer software to help discussion.

尽管医院收集了大量的事件报告以改善患者安全管理，但很难消除所有医疗错误。危险与可操作性研究（Hazard And Operability Studies，HAZOP）是20世纪70年代在化工厂等过程工业中发展起来的风险分析方法之一。HAZOP由三个步骤组成，逐步分析操作（称为工作分解结构），讨论错误原因和后果，并将其映射到风险矩阵。HAZOP与FMEA（Failure Mode and Effect Analysis）不同的主要特点是，通过引导词进行讨论，能够涵盖所有的可能性。为了将HAZOP作为医疗安全管理的新教育方法，我们与住院医师、骨科医生、护士和合作医疗人员进行了大量的小组试验。住院医师培训的主题为气管插管、硬膜外导管、中心静脉置管;医生培训的主题为内窥镜腰椎间盘手术、全髋关节置换术;合作医护人员培训的主题为住院患者意外跌倒、处方管理。一个需要解决的问题是一次会议花费太多时间，我们计划开发计算机软件来帮助讨论。