Hospital Quality Control in China

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Lauren Ramsey
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1 Hospital Quality Control in China Hengjin Dong, MD, PhD Prof. and Executive Director Center for Health Policy Studies Zhejiang University School of Medicine To Err Is Human: Building a Safer Health System Deaths due to medical errors exceed those from motor vehicle accidents, breast cancer, or AIDS Over half of these adverse events resulted from medical errors could have been prevented Total national costs (lost income, lost household production, disability and health care costs) of preventable adverse events (medical errors resulting in injury) are estimated to be between $17 billion and $29 billion To Err Is Human: Building a Safer Health System. Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Editors; Committee on Quality of Health Care in America, Institute of Medicine. ISBN: , 312 pages, 6 x 9, (2000) 1

vehicle accidents, breast cancer, or AIDS Over half of these adverse events resulted from medical errors could have been prevented Total national costs (lost income, lost household production,

2 Main conclusions 1. The majority of medical errors do not result from individual recklessness 2. More commonly, errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them 3. Thus, mistakes can best be prevented by designing the health system at all levels to make it safer--to make it harder for people to do something wrong and easier for them to do it right. Recommendations 1. Establishing a national focus to create leadership, research, tools and protocols to enhance the knowledge base about safety 2. Identifying and learning from errors through immediate and strong mandatory reporting efforts, as well as voluntary efforts, to make sure the system continues to be made safer for patients 3. Raising standards and expectations for improvements in safety through the actions of oversight organizations, group purchasers, and professional groups; and 4. Creating safety systems inside health care organizations through the implementation of safe practices at the delivery level 2

Thus, mistakes can best be prevented by designing the health system at all levels to make it safer--to make it harder for people to do something wrong and easier for them to do it right.

3 Development After 5 years, a well-developed medical risk management system was established with the improvement in the public awareness of medical errors, patient safety, performance criteria of medical safety, information technology, and error reporting system 78 patient safety organizations Patient Safety is a global issue % of acute admissions USA 3.7% Australia 16.6% England 10.8% Denmark 9% New Zealand 12.9% Canada 7.5% Japan 11% Glenn Pascoe, our way for patient safety. Cambridge university hospital 3

system 78 patient safety organizations Patient Safety is a global issue 18 16 14 12 10 8 6 4 2 0 % of acute admissions USA 3.

4 China patient safety Officially report: 924 medical accidents in 2008, and 583 in 2009 Hospital-related infection: 0.9% in 2007, 0.8% in 2008 and 2009 But some researches report: 5%, ICU 20% 25-33% of the infected patients died 12-32% of patients misuse drugs 40% of medical errors are preventable Economic loss: 15 billion Yuan/year Medical errors related to medical device In 2008, China had medial errors related to medical device, 3.3 times of those in 2007; 37 patients died likely due to the errors For example, in 2008, one province had 1806 medial errors related to medical device, resulting in deaths, fire and injuries It is found that some medical equipment or device have safety issues, such as monitors, Ventilators. 4

billion Yuan/year Medical errors related to medical device In 2008, China had 40940 medial errors related to medical device, 3.

5 China strategy for hospital quality control To set up local medical quality control center since 2009 Local center makes relevant law, regulation, technical guidelines of diagnosis and treatment, criteria and procedure of quality control To set up hospital-related infection monitor network in 2001 Performance of quality control Some hospitals do not pay attention to the hospital quality, or they only talk hospital quality, but there are no actions. They may have some regulations, but in practice they don t follow them. Some hospitals make regulations or procedure, but do not pay attention to the error report and analysis. Sometimes, they hide the errors. Most hospitals still use experience or traditional measures to control hospital quality. Some hospitals use standard procedure for quality control, such as to follow the regulations or technical guidelines, to analyze the errors and to take measures to avoid medical errors. Only a few hospitals use ISO9000 for comprehensive hospital quality control. 10 5

they only talk hospital quality, but there are no actions. They may have some regulations, but in practice they don t follow them.

6 Suggestions Patient right Patient safety is hospital s responsibility Public awareness of medical errors Error reporting system Research Enforce leadership Patient involvement Computer control system 11 Tel: [email protected] 谢谢! 6

reporting system Research Enforce leadership Patient

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