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目的探讨失效模式与效应分析(FMEA)在医疗机构传染病报告工作中风险管理的应用。方法由省、市、区三级疾病预防控制中心各3人,三级医院各2人和民营医院1人,共16名专家组成FMEA专家小组,通过头脑风暴法和专家访谈(咨询)法,分别确定医疗机构传染病报告工作流程环节及潜在失效模式,并分项计算风险数(RPN),将其从高到底排序制定FMEA分析表。结果经专家小组评估,该项工作流程有17个管理环节,其中RPN值排名前5位的流程环节依次为医疗机构领导小组重视程度(182.00)、临床医师及疫情报告人员职业素质和报告意识(168.00)、考核指标(146.25)、医院报告系统信息化建设(135.00)和辅助科室异常结果反馈机制(108.00)。结论应用FMEA可识别和处理传染病疫情报告过程中的失效模式,为医疗机构传染病疫情报告与管理的风险评估提供依据。
Objective To explore the application of failure mode and effect analysis (FMEA) in risk management of infectious diseases reporting in medical institutions. Methods A total of 16 experts composed of 3 experts from 3 centers for disease prevention and control in provincial, municipal and district levels, 2 in tertiary hospitals and 1 in private hospitals were selected. Through brainstorming and expert interviews (consulting) Respectively, medical institutions, infectious disease reporting workflow links and potential failure modes, and calculate the number of risks (RPN), sorted from top to bottom to develop FMEA analysis table. The results of the assessment by the expert group, the workflow has 17 management links, of which the top five RPN value of the process links were the importance attached to the leading group of medical institutions (182.00), clinicians and epidemics reporting professional quality and reporting awareness 168.00), assessment indicators (146.25), hospital reporting system information construction (135.00) and ancillary departments abnormal result feedback mechanism (108.00). Conclusion The application of FMEA can identify and process the failure modes in the reporting of epidemic situation of infectious diseases and provide the basis for the risk assessment of epidemic situation reporting and management of infectious diseases in medical institutions.