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的标准化管理在急危重症医学中已经显得力不从心。在这项研究中，我们澄清了急诊和危重医疗以及其他医疗保健的区别，比较了医疗保健的框架。主要研究结果如下：1)大多数外科医生以“术前-手术-”为主要框架，以出血、感染等并发症为分支。在内科，由于慢性病很少能治愈，医生们熟悉症状的恶化和缓解。在急诊和重症监护医学中，生命体征的稳定在急性期是最重要的。2)因此，每个科室对具有相同症状的患者的处理方法是不同的。3)传统诊断学强调主诉为医疗风险。4)介绍和分析了重症监护病房(ICU)的临床营养路径，作为ICU的质量控制。5)共享团队医疗成果。总之，医疗保健的框架，即医生的思维路线，应该在医务人员之间共享。

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.