妇幼医院管理案例-妇幼保健领域中医院管理与质量控制.ppt

1、妇幼医院管理案例妇幼保健领域中医院管理与质量控制 2 3The Maternity Centre 妇产中心 Over 3000 babies delivered each year 年均3000新生儿 68%delivered naturally,18%Cesarean Section,14%instrumental delivery 68%自然分娩,18%剖腹产，14%辅助分娩（使用产钳、硬膜外等）24 hour access to advice from midwives 助产士24小时值班 One to one care throughout labour 整个分娩过程1对1助产士陪伴

2、On-site Special Baby Care unit 新生儿特需监护病房 On site(adult)emergency facilities including theatre and intensive care 急救室（包括手术室和危重急救）At the Maternity Centre our aim is to facilitate a positive birth experience in a safe,sensitive,supportive and friendly environment 53Person-centred 以人为本:providing care th

3、at is responsive to individual personal preferences,needs and values and assuring that patient values guide all clinical decisions响应患者个人偏好、需求和价值观来提供医疗服务，确保临床决策尊重患者意愿Timely 适时:reducing waits and sometimes harmful delays for both those who receive care and those who give care.不管是对患者，还是医院工作者而言，尽量减少等待和伤

4、害性延误Efficient 高效:avoiding waste,including waste of equipment,supplies,ideas,and energy;避免包括设备、物资、理念和精力等资源的浪费Safe 安全:avoiding injuries to patients from healthcare that is intended to help them避免在医疗过程中对患者造成伤害Effective 效果:providing services based on scientific knowledge基于科学知识提供服务Equitable 公平:providing

5、care that does not vary in quality because of personal characteristics such as gender,ethnicity,geographic location or socio-economic status所提供的医疗服务质量不因个人特征如性别、种族、地理定位或社会经济地位不同而改变Quality in Care 医疗质量Quality in Care医疗质量Clinical and Risk Management Effectiveness临床和风险管理效力Safe and Effective安全和有效Set evid

6、ence based standards coupled with robust check to ensure adherence to standards through:通过以下方式制定循证标准及稳健的检查以确保遵守标准：Encouraging incident reporting 鼓励事故报告 Investigating and learning from variances 从差异中研究和学习 Carrying out maternal and perinatal death reviews 实施孕产妇及围产期死亡审查 Undertaking clinical audits 着手临床

7、审计 Design and change systems with the patient and her family in mind 与患者和患者家属设计和更改系统Perinatal Death Reviews围产期死亡审查Many perinatal deaths are preventable.Well implemented death reviews provide opportunities to examine the circumstances surrounding a childs death,and improve the delivery of health serv

8、ices to prevent such deaths in the future.许多围产期死亡事件是可以预防的，负责任地落实死亡审查，检查死亡婴儿周围环境，能够帮助预防未来可能发生类似情形的死亡。The Birmingham Reducing Perinatal Mortality Project(Martin and Gardosi 2007)aims to increase to 60%,detection rates of growth restricted fetuses through a programme of enhanced community care,includin

9、g use of customised fetal growth charts and training and accreditation of clinical assessment of fetal growth using a tape measure.伯明翰降低围产期死亡率项目（Martin and Gardosi 2007）旨在通过加强社区护理计划，使用定制胎儿生长图表、制定标准培训、认证胎儿生长的临床评估,将胎儿增长限制的检出率提升至60%。Patient Experience and Communication Effectiveness患者体验和沟通效果Equitable a

10、nd Person Centred公平与以人为本Ensure and confirm that you are providing care that is acceptable to the woman by:通过以下方式确保并确认能为孕产妇提供可接受的护理：Inviting feedback at the point of patient care 从患者护理中获取患者反馈 Undertake care observation 做患者保健观察 Investigate and learn from patient complaints and feedback 从患者投诉和反馈中研究和学习

11、Investigate and learn from incidents 从突发事件中研究和学习 Communicate effectively providing verbal and written information 从有效沟通中获取口头和书面信息 10 11 12 13Learning from Patient Complaints and Feedback从患者投诉和反馈中学习Our families asked for their husbands and partners to stay with them overnight to help with the care of

12、 the baby.We have set up a process to enable that to happen为了方便照顾新生儿，家属要求丈夫和伴护夜里也能够和她们待在一起。我们已经设立了相关程序，希望可以满足这一要求。Some of our families whose baby dies before the birth complained that the room they were cared in was too small and too close to women whose babies were born alive.We are currently build

13、ing the new room with input from women who lost their babies.一些胎儿出生便死亡的家庭投诉称他们所处的病房太小或者离胎儿出生存活的孕产妇病房太近。我们正在为那些失去自己孩子的产妇单独建设新的房间。Resource and Strategic Effectiveness资源和战略性的效率Efficient and Timely高效和适时Ensure that you are providing care that is timely and efficient by:通过以下方式确保所提供的护理是适时和高效的：Providing car

14、e close to home 为患者住家所在地附近提供可及护理 Delivered according to timetabled standards 根据时间表标准提供医疗服务 Providing clinics with all the professionals required to provide the correct one stop care i.e.Obesity Clinics,Diabetic Clinics 为门诊提供所需的所有能够提供正确的“一站式”护理的专业人员：如肥胖症门诊和糖尿病门诊 Monitor waiting lists 监控患者等候名单 Monitor

15、 cost effectiveness 监控成本效益.16 17Chair 椅子Hysterescopy宫腔镜Digital Screen电子屏幕Colposcopy 阴道镜Ultrasound超声检查RecoveryRoom病人休息室En-suite 卫生间、淋浴室PC&Desk办公桌、电脑椅子椅子洗手池One Stop Out-paitent Clinic in Gynecology妇科一站式门诊妇科一站式门诊（All in one room，全部在一个房间内全部在一个房间内）门门 18One Stop Out-paitent Clinic in Gynecology妇科一站式门诊妇科一站

16、式门诊（All in one room，全部在一个房间内全部在一个房间内）Colposcopy(阴道镜)Hysterescopy(宫腔镜)Early pregnancy clinic (妊娠早期门诊)Suspected cancer clinic(疑似癌症诊断门诊)Sterilization clinic(绝育手术)Bladder Bulking Agent Injection(膀胱膨胀剂注射)Endometrial Ablation Clinic(子宫内膜切除手术)Performance oversight 绩效监督 Consistent oversight and performance

17、frameworks in place across the trust to ensure quality and sustainability of services;Monthly divisional performance meetings with Womens Health division to oversee performance against national and locally set standards as outlined in the Obstetrics Quality Quartet;Defined criteria for escalation an

18、d support for areas of challenge or underperformance in year;including clear routes for escalation to Executive Board;Division supported by dedicated finance and HR business partners;centralised performance and PMO team.通过信托一致性监管和绩效框架确保服务的质量和可持续性；月度部门绩效要与女性健康部门要求符合，针对国家和本地产科质量四重奏标准来监管绩效；为升职、高难度领域的支持

19、或表现不佳定义相关标准；包括明确升职进入执行委员会的路线；部门由专门的财务和人力资源业务伙伴来支持管理；将绩效和项目管理办公室团队集中化 Obstetrics Quality Quartet产科质量四个模块Staff and leadership员工和领导Staff 员工 Engage the staff 员工参与 Communicate and Inform沟通和知情 Support frontline innovation 支持前沿创新 Support the staff at all times无论何时都支持员工 Educate for the work and for themselv

20、es针对员工工作和个人发展展开教育 Appraisal 评估Leadership 领导 Inspire shared purpose 鼓励共享的目的 Lead with Care 领导与关怀 Evaluate information 评估信息 Connect Servces 联系服务 Share Vision 共享视角 Engage with the Team 和团队融为一体 Hold to Account 承担责任 Develop Capability 发展能力 Influence for Excellent Results 影响产生好的结果22Support Frontline Innov

21、ation支持前沿创新Our Research Midwife had an idea that we could reduce our induction of labour rate using complementary therapies.我们的助产士研究员建议可以通过使用补充疗法来减少引产术率With some support from the Head of Midwifery she introduced the service.在助产学负责人支持下，该研究员引入这项医疗服务She won an award.并因此获奖。The money from the award paid for other midwives to train and for our research midwife to go to University to undertake further research.所得奖金用于培训其他助产士以及支持该助产士研究员进入大学做进一步研究。The induction of labour rate came down 引产术使用率下降The women loved the new service 孕产妇们都十分钟爱这项新的医疗服务 24