Study of Medical Risk and Quality Management for Critical Care Medicine Using Framework of Medical Care

医疗风险或医疗质量管理的标准化在急诊和危重症医疗中一直存在不足。在本研究中，我们澄清了急诊和重症医学以及其他类型医疗保健的区别，比较了医疗保健的框架。我们得到的主要结果如下：1)大多数外科医生认为“术前-手术-术后>”为主要框架，出血、感染等并发症为分支。在内科，由于慢性病很难治愈，医生对症状的加重和缓解都很熟悉。在急诊和重症医学中，生命体征的稳定在急性期是最重要的。2)因此，对于相同症状的患者，各个科室的治疗方法是不同的。3)传统诊断强调主诉为医疗风险。4)介绍并分析了重症监护病房（ICU）营养质量控制的临床路径。5)共享团队医疗成果。总之，医疗服务的框架，医生的思维路线，应该在医护人员之间共享。

Medical risk or quality management by the standardization of medical care has been insufficient in emergency and critical care medicine. In this study, we clarified the difference between emergency and critical care medicine, and other kinds of medical care, comparing the frameworks of medical care. The main results we obtained are as follows: 1) Most surgeons recognize the framework of "preoperation --> operation --> postoperation" as the main framework, and complications like bleeding and infection as branches. In internal medicine, because chronic diseases are rarely curable, doctors are familiar with the exacerbation and relief of symptoms. In emergency and critical care medicine, the stabilization of vital signs is the most important in the acute phase. 2) Therefore, approaches to patients with the same symptoms are various in each department. 3) Traditional diagnostics emphasize chief complaints as medical risks. 4) We introduced and analyzed a clinical pathway for nutrition in the intensive care unit (ICU) as quality control in the ICU. 5) We should share outcomes for team medicine. In conclusion, the framework of medical care, the doctor's thinking route, should be shared between medical staff.