英美加澳和中国台湾地区医疗风险管理方法与评估工具的比较研究

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英美加澳和中国台湾地区医疗风险管理

方法与评估工具的比较研究

成岚1孙纽云2王莉1梁铭会2李幼平1袁强1崔小花1李筱1

四川大学华西医院中国循证医学中心(成都610041);卫生部医院管理研究所(北京100083)

目的 比较英美加澳与中国台湾地区医疗风险管理方法与评估工具,为我国医疗风险管理提供决策依据和政策建议。方法 计算机检索英美加澳与我国台湾地区政府机构和行业协会或学术团体的官方网站,查找并纳入与医疗风险管理与监测相关的法律、规范性文件、研究报告、综述和评价表格等,而后采用描述性对比分析方法,综合比较上述四国一区医疗风险管理方法与评估工具。结果①共纳入17篇规范性文件,41篇指南,37篇综述和49篇一般信息,共计146篇文献;②英国采用整合风险管理,澳大利亚和台湾采用经典风险识别、分析、评估与控制方法,美国和加拿大采用前瞻性FMEA方法识别与评估临床风险;③在医疗风险评估分级方面,英、澳将医疗风险严重程度分为5级,台湾分为6级;发生频率均分为5级;应对响应均按4级标准。④四国一区RCA分事件对象略有不同,RCA步骤与工具基本一致。结论 英美加澳与我国台湾地区主要采取前瞻性风险评估、基于已发生不良事件的风险评估及整合风险管理三种医疗风险管理模式,且评估工具相同;英、澳和我国台湾地区临床医疗风险分级大致相同,但分级定义有差异;四国一区不良事件分析方法与过程基本一致。

医疗风险;风险管理;风险评估

Comparative Analyses on Methods and Tools for Medical Risk Management and 

Assessment in the United Kingdom, the United States, Canada, Australia and 

Taiwan Region

CHENG LanSUN Niu-yunWANG LiLIANG Ming-huiLIYou-pingYUAN Qiang

CUI Xiao-huaLI Xiao

成岚,女,硕士研究生,以循证决策与管理为主要研究方向。Email: aminta_714@163.com

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@@11.台湾行政院卫生署.根本原因分析法学员版手册.[2010-10- 6] Available from: URL: http://60.248.196.52/FrontStage/page. aspx?ID=5BAB09FB-BD56-403F-990A-E5CCDAFB2198.

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