美英加澳和中國臺灣地區醫療不良事件上報系統管理模式的比較研究△_《中國循證醫學雜志》

作者：

崔小花 ¹ , 孫紐云 ² ,  李幼平 ¹ , 張宗久 ³ , 王莉 ¹ , 周軍 ³ , 梁銘會 ² , 成嵐 ¹ , 高光明 ³ , 袁強 ¹

1. 四川大學華西醫院中國循證醫學中心（成都 610041）；2. 衛生部醫院管理研究所（北京 100083）；3. 衛生部醫療服務監管司（北京 100044）;

關鍵詞：

醫療風險預警監測管理模式比較研究

DOI：

10.7507/1672-2531.20110040

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　“醫療風險無處不在”已成為全球醫療界的共識。有關病人安全的文獻量和報告數都在快速增長，但對其概念的解讀和比較尚缺乏共識。本研究通過比較美英加澳和我國臺灣地區醫療風險管理的概念、政策法規、機構管理和運行機制等，為我國醫療風險管理提出決策依據和政策建議。
方法　計算機檢索美國、英國、加拿大、澳大利亞和我國臺灣地區政府機構和行業協會或學術團體的官方網站，納入其醫療風險管理與監測的相關法律、規范性文件、研究報告、綜述和評價表格的文獻，按法律法規、規范性文件或指南、綜述和一般信息分類分級，并采用描述性對比分析方法，系統比較其風險管理機構、法規和運行機制。
結果　① 共納入146篇文獻，包括2篇法律法規，17篇規范性文件，41篇指南，37篇綜述和49篇一般信息；② 上述四國一區中僅美國頒布了2部病人安全的法律，僅英國和澳大利亞各發布了1個病人安全指南；③ 四國的病人安全管理機構設置均為國家、州/省/地區、醫院和NGO或其他機構（協會）等四級結構管理、協同工作。
結論　① 四國一區中，僅美國以法律的形式為病人安全與醫療管理提供法律保障，英國和澳大利亞衛生部以行業指南的形式為病人安全提供政策保障。② 四國一區的病人安全機構設置均為中央、地方、機構和NGO四級結構，運行機制大致分為以美國、加拿大為代表的非政府組織主導協同工作，和以英國、澳大利亞為代表的國家政府主導的兩種模式。我國臺灣地區病人安全管理機構屬于地方二級機構。

引用本文： 崔小花,孫紐云,李幼平,張宗久,王莉,周軍,梁銘會,成嵐,高光明,袁強. 美英加澳和中國臺灣地區醫療不良事件上報系統管理模式的比較研究△. 中國循證醫學雜志, 2011, 11(3): 237-246. doi: 10.7507/1672-2531.20110040 復制

1.	1 Sun NY, Wang L, Zhou J, et al . International comparative analyses of healthcare risk management. Journal of Evidence-Based Medcine , 2011, 4(1):.
2.	ISMP Medication Errors Reporting Program (MERP). [2010-8-6] Available from: URL:https://www.ismp.org/orderforms/reporterrortoismp.asp.
3.	The Joint Commission.Sentinel Event Policy.[2010-8-2] Available from: URL:http://www.jointcommission.org/NR/rdonlyres/F84F9DC6-A5DA-490F-A91F-A9FCE26347C4/0/SE_chapter_july07.pdf.
4.	The Joint Commission. Alternatives for Sharing Sentinel Event-Related Information with The Joint Commission. [ 2010-8-2] Available from: URL:http://www.jointcommission.org/SentinelEvents/ReportingAlternatives/.
5.	USP. MEDMARX. [2010-8-2] Available from: URL: http://www.usp.org/hqi/patientSafety/medmarx/.
6.	Quantros Safety & Risk Management review. 2010-8-2http://www.quantros.com/pdf/Quantros_SRM_Overview-2010.pdf.
7.	The Journal’s Editorial Staff. A National Survey of Medical Error Reporting Laws. Yale Journal Of Health Policy, Law, And Ethics. IX:1 (2008) Available from: URL: http://www.yale.edu/yjhple/volume9issue1/p201-286_Feature%20TO%20PRINT.pdf.
8.	CDC.National Healthcare Safety Network (NHSN) Overview. [2010-8-10] Available from: URL:http://www.cdc.gov/nhsn/PDFs/pscManual/1PSC_OverviewCurrent.pdf.
9.	NPSA. Seven steps to patient safety.[2010-8-6] Available from: URL:http://www.nrls.npsa.nhs.uk/resources/collections/seven-steps-to-patient-safety/?entryid45=59787.
10.	NPSA Five actions to improve patient safety reporting.[2010-8-6] Available from: URL:http://www.nrls.npsa.nhs.uk/resources/?entryid45=59903.
11.	NPSA. National Framework for Reporting and Learning from Serious Incidents Requiring Investigation.[2010-8-16] Available from: URL: http://www.nrls.npsa.nhs.uk/resources/?entryid45=75173.
12.	CIHI. The Development of a Canadian Medication Incident Reporting and Prevention System (CMIRPS) for Canada.[2010-10-4] Available from: URL: http://www.hc-sc.gc.ca.
13.	Institute for Safe Medication Practices Canada (ISMP). Canadian Medication Incident Reporting and Prevention System. [2010-10-4] Available from: URL: www.ismp-canada.org.
14.	NPSF. Advanced Incident Management System (AIMS).[2010-8-23] Available from: URL:http://www.apsf.net.au/products.php.
15.	Isoft Health.iSOFT Solution Overview.[2010-8-30] Available from: URL:http://www.isofthealth.com/en/~/media/A776EC4BB2E945E4840F7896792BFBF9.ashx.
16.	臺灣行政院衛生署. 臺灣病人安全通報系統病人安全通報單（第五版）. [2010-11-2] Available from: URL: http://www.tpr.org.tw/dl/TPR_5(13)C.pdf.
17.	臺灣行政院衛生署. 臺灣病人安全通報系統介紹. [2010-10-4] Available from: URL: http://www.tpr.org.tw/index01.php.

1. 1 Sun NY, Wang L, Zhou J, et al . International comparative analyses of healthcare risk management. Journal of Evidence-Based Medcine , 2011, 4(1):.
2. ISMP Medication Errors Reporting Program (MERP). [2010-8-6] Available from: URL:https://www.ismp.org/orderforms/reporterrortoismp.asp.
3. The Joint Commission.Sentinel Event Policy.[2010-8-2] Available from: URL:http://www.jointcommission.org/NR/rdonlyres/F84F9DC6-A5DA-490F-A91F-A9FCE26347C4/0/SE_chapter_july07.pdf.
4. The Joint Commission. Alternatives for Sharing Sentinel Event-Related Information with The Joint Commission. [ 2010-8-2] Available from: URL:http://www.jointcommission.org/SentinelEvents/ReportingAlternatives/.
5. USP. MEDMARX. [2010-8-2] Available from: URL: http://www.usp.org/hqi/patientSafety/medmarx/.
6. Quantros Safety & Risk Management review. 2010-8-2http://www.quantros.com/pdf/Quantros_SRM_Overview-2010.pdf.
7. The Journal’s Editorial Staff. A National Survey of Medical Error Reporting Laws. Yale Journal Of Health Policy, Law, And Ethics. IX:1 (2008) Available from: URL: http://www.yale.edu/yjhple/volume9issue1/p201-286_Feature%20TO%20PRINT.pdf.
8. CDC.National Healthcare Safety Network (NHSN) Overview. [2010-8-10] Available from: URL:http://www.cdc.gov/nhsn/PDFs/pscManual/1PSC_OverviewCurrent.pdf.
9. NPSA. Seven steps to patient safety.[2010-8-6] Available from: URL:http://www.nrls.npsa.nhs.uk/resources/collections/seven-steps-to-patient-safety/?entryid45=59787.
10. NPSA Five actions to improve patient safety reporting.[2010-8-6] Available from: URL:http://www.nrls.npsa.nhs.uk/resources/?entryid45=59903.
11. NPSA. National Framework for Reporting and Learning from Serious Incidents Requiring Investigation.[2010-8-16] Available from: URL: http://www.nrls.npsa.nhs.uk/resources/?entryid45=75173.
12. CIHI. The Development of a Canadian Medication Incident Reporting and Prevention System (CMIRPS) for Canada.[2010-10-4] Available from: URL: http://www.hc-sc.gc.ca.
13. Institute for Safe Medication Practices Canada (ISMP). Canadian Medication Incident Reporting and Prevention System. [2010-10-4] Available from: URL: www.ismp-canada.org.
14. NPSF. Advanced Incident Management System (AIMS).[2010-8-23] Available from: URL:http://www.apsf.net.au/products.php.
15. Isoft Health.iSOFT Solution Overview.[2010-8-30] Available from: URL:http://www.isofthealth.com/en/~/media/A776EC4BB2E945E4840F7896792BFBF9.ashx.
16. 臺灣行政院衛生署. 臺灣病人安全通報系統病人安全通報單（第五版）. [2010-11-2] Available from: URL: http://www.tpr.org.tw/dl/TPR_5(13)C.pdf.
17. 臺灣行政院衛生署. 臺灣病人安全通報系統介紹. [2010-10-4] Available from: URL: http://www.tpr.org.tw/index01.php.

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