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1、他山之石:,国际患者安全实践的经验与启示,CEO s Speech(2016),Fifteen Years of Patient Safety Milestones 十五年患者安全里程碑 Learn how Johns Hopkins has built a culture of accountability and advanced patient safety. 学习约翰霍普金斯医院怎样建设责任文化与一流患者安全,1. “I am so sorry.” With support from Johns Hopkins leadership, Johns Hopkins Childrens C
2、enter Director George Dover apologizes to Josie Kings parents and acknowledges that preventable medical errors led to her death. The Kings use money from their settlement to fund safety programs at Johns Hopkins. 约翰霍普金斯医院儿童中心负责人向乔瑟金的父 母道歉。乔瑟金家庭在约翰霍普金斯医院设立患者 安全项目。,2. Safety As Top Priority. The Cente
3、r for Innovation in Quality Patient Care is created with donations of $500,000 each from The Johns Hopkins University, The Johns Hopkins Hospital and the school of medicine. Richard “Chip” Davis becomes executive director, and Peter Pronovost is named medical director. 把安全放在首位。约翰霍普金斯大学、约翰霍普 金斯医院和医学院
4、共同捐资成立患者医护质量创新中 心。,3. Better Research Oversight. Johns Hopkins overhauls its Institutional Review Board (IRB) system after Ellen Roches death and a temporary federal government shutdown of all research protocols. All proposals and their progress are thoroughly reviewed. Intervention plans are requir
5、ed in case a volunteer has an adverse reaction. An electronic medical record system also improves patient safety by ensuring that clinicians have access to research data relevant to patient care. 加强临床研究监管。改革医院内部审查机制，对 所有研究项目进行评估，一旦有自愿者发生不良 反应，及时采取干预措施。改善电子病历系统， 让临床医生可获取患者照护相关的研究资料。,4. The Science of
6、 Safety. Johns Hopkins safety experts apply scientific rigor to understanding and preventing medical errors. They test possible interventions, translate the research into practice and scale programs for use in care facilities worldwide. Articles include original research, viewpoints and reviews auth
7、ored by faculty and staff members actively engaged in projects in the Armstrong Institute and published in peer-reviewed journals. 追求医疗安全的科学性。医院安全专家用严 格的科学方法研究和预防医疗差错。,5. The Checklist. Pronovost distills 120 pages of information from the Centers for Disease Control and Prevention into a five-step c
8、hecklist for preventing central line-associated bloodstream infections (CLABSIs). The checklist helps reduce CLABSIs in intensive care units by 80 percent nationwide. 创用核对表。创制预防中心静脉导管相关血 流感染（CLABSIs）的核对表，使全美ICU 的CLABSIs 发生率减少80%。,6. Changing the Culture, One Unit at a Time. The Comprehensive Unit-ba
9、sed Safety Program (CUSP) creates a culture of accountability, giving front-line staff members knowledge and support to tackle safety hazards, such as patient falls and medication errors. More than 170 CUSP teams are active across the health system, and the concept is adapted for hospitals worldwide
10、. 改变文化，一次一个科室。以科室为单位的安全计 划实现责任文化，给一线人员相关知识和支持。170 个CUSP团队遍布整个医院系统，其理念为世界各 国医院所采纳。,7. A Patient Safety Workforce. Patient advocates are hired to develop intervention programs and rapid response protocols. With new training and orientation programs, nurses, engineers and risk managers become patient s
11、afety leaders. 患者安全人力资源。聘请患者代表来制定干预 计划和快速反应方案。护士、工程技术人员和 危机处理者成为患者安全领导者。,8. Speaking Up and Speaking Out. Johns Hopkins implements an incident reporting system to better understand medical errors and how to prevent them. Work units take safety culture surveys to highlight successes and areas for imp
12、rovement. 大胆讲出来。约翰霍普金斯医院建立和运行不 良事件报告系统，以及时了解和预防医疗差错。 医院有关部门开展安全文化调查，肯定成绩，找 出不足。,9. Caring for Second Victims. The Resilience in Stressful Events (RISE) program provides psychological first aid to “second victims,” the clinicians who experience stress and remorse because of adverse patient outcomes.
13、关心次生受害者。压力事件缓冲计划对次生受害 者，即经历了压力事件，并因患者不良事件后果 而懊悔的临床医护人员，提供心理救护。,10. Patients as Partners. The Johns Hopkins Childrens Center creates the Pediatric Family Advisory Council steering committee with parents and staff members. Similar councils are now active in every Johns Hopkins Medicine hospital, commu
14、nity physicians group and home care group. 视患者为伙伴。约翰霍普金斯儿童中心建立了 儿科家庭咨询委员会对儿童家长和医护人员进行 指导。现在，类似组织活跃在约翰霍普金斯医 院、社区医生团队和家庭照护团队中。,11. Building a Strong Infrastructure. Johns Hopkins creates the Armstrong Institute for Patient Safety and Quality in 2011 with a $10 million gift from C. Michael Armstrong, c
15、hairman of the Johns Hopkins Medicine board of trustees from 2005 to 2013. 加强基础性工作。约翰霍普金斯成立了阿姆 斯特朗患者安全与质量研究所。,12. Sharing Successes. The Armstrong Institute combines rigorous patient safety research with health system operations to create and deploy safety programs and metrics for measuring best pra
16、ctices. By 2015, all six hospitals are nationally recognized for high-quality care, and Johns Hopkins programs and safety metrics are adopted around the world. 分享成功经验。阿姆斯特朗研究所将患者安全研 究与医疗系统运行结合起来，建立和部署患者安 全计划，形成评价优质医疗服务的指标体系。到 2015年，所有6家医院进入全美高质量照护医院 行列，约翰霍普金斯安全计划和安全评价指标 体系为世界各国医院所应用。,13. Safety During Global Crisis. The Armstrong Institute develops a Web-based training program to educate health care workers in government- approved safety procedures for infectious disease outbr
