Razvoj kazalnikov kakovosti v pljučni kirurgiji

magistrsko delo Management v zdravstvu in socialnem varstvu

Aleksandra Jerič (Author), Matjaž Maletič (Mentor)

Abstract

Magistrsko delo obravnava razvoj kazalnikov kakovosti v zdravstveni negi pljučne kirurgije. V delu smo z različnimi orodji managementa kakovosti prikazali sistem za razvoj kazalnikov kakovosti, s katerimi lahko spremljamo uspešnost in učinkovitost procesa zdravstvene nege pacienta pri operaciji pljuč. V empiričnem delu smo s SIPOC metodo in procesnim modelom opisali klinično pot pacienta pri operaciji pljuč. Popis procesa zdravstvene nege pacienta pri operaciji pljuč smo analizirali z analizo možnih napak in njihovih posledic – FMEA metoda. S pomočjo strokovne literature ter strokovnega zdravstvenega delavca smo identificirali možne napake, katere se v procesu zdravstvene nege lahko pojavijo. Z analizo anketnega vprašalnika smo za vsako napako z izračunanim povprečjem pridobili tri faktorje. Prvi faktor je verjetnost nastopa napake, drugi je teža napake in zadnji verjetnost odkritja napake. Zmnožek teh nam poda skupno tveganje potencialnih napak oziroma indeks pomembnosti napake (IP). S Pareto diagramom smo pridobili pet potencialnih napak, katere skupaj predstavljajo 21,82 % vseh indeksov pomembnosti. Kar pomeni, da pojav teh petih napak predstavlja najvišje tveganje pri izvajanju kakovostne zdravstvene nege pacienta pri operaciji pljuč. Za vsako izmed petih napak z najvišjim indeksom pomembnosti smo izpeljali naslednje kazalnike kakovosti: • Število alergijskih reakcij na zdravila / 200 pljučnih operacij • Številno napak pri izpolnjevanju dokumentacije / 200 pljučnih operacij • Številno nepopolnih premedikacij zaradi nedosledno izpolnjenega temperaturnega lista / 200 pljučnih operacij • Število nedoslednih diagnoz, katerih posledica ja nepopolna anamneza pacienta / 200 operacij • Število pacientov s pnevmotoraksom zaradi lastne odstranitve drenaže / 200 pljučnih operacij Poudariti moramo, da je za zdravstvene ustanove pomembno, da kakovost svojih storitev neprestano spremljajo in izboljšujejo. Predlagamo, da torakalne klinike stalno spremljajo kazalnike kakovosti, pridobljene v tem delu. V primeru spremembe procesa nege predlagamo, da kazalnike kakovosti prenovijo po sistemu, ki je prikazan v tej nalogi. Ob enem pa je prikazan sistem za razvoj kazalnikov kakovosti, primeren tudi za vse ostale procese, ki se odvijajo v zdravstveni negi.

Keywords

kakovost v zdravstvu;kazalniki kakovosti;kazalniki kakovosti v zdravstvu;

Data

Language:	Slovenian
Year of publishing:	2017
Typology:	2.09 - Master's Thesis
Organization:	UM FOV - Faculty of Organizational Sciences
Publisher:	[A. Jerič]
UDC:	005.336.3
COBISS:	7956499
Views:	1051
Downloads:	177
Average score:	0 (0 votes)
Metadata:

Other data

Secondary language:	English
Secondary title:	The development of quality indicators in lung surgery
Secondary abstract:	The Master's Thesis examines the development of quality indicators in healthcare of pulmonary surgery. In our work, we have demonstrated a system for the development of quality indicators using various quality management tools to monitor the effectiveness and efficiency of the patient's healthcare process in the lung operation. In the empirical part, the patient's clinical pathway for lung surgery was described with the SIPOC method and process model. The patient's healthcare process in lung surgery was analysed with FMEA method (Failure mode and effects analysis), where we identified all the possible failures, based on professional literature and the practice of a professional healthcare worker. For calculating Risk Priority Number (RPN), we calculated Mean for all three factors: Severity (of the event), Probability (of the event occurring) and Detection (Probability that the event would not be detected before the user was aware of it). Based on Pareto analysis we obtained five potential failures, which they together represent 21.82% of all RPNs. That means that occurrence of this five failures represents the highest risk in quality healthcare for patients. The quality indicators we developed for each of this five failures with the highest RPN are: • Number of allergic reactions to medicines / 200 pulmonary operations • Number of errors in documentation fulfilment / 200 pulmonary operations • Number of incomplete premedications due to incompletely filled temperature chart / 200 pulmonary operations • Number of inconsistent diagnoses, which is the consequence of incomplete patient history / 200 pulmonary operations • Number of patients with pneumothorax due to their own removal of drainage / 200 pulmonary operations It should be emphasized that it is important for healthcare institutions to constantly monitor and improve the quality of their services. We suggest that thoracic clinics constantly monitor the quality indicators obtained in this Thesis. In case of any changes in the process, we suggest that the clinic reclassifies quality indicators according to the system shown in this Thesis. We think that the system for developing quality indicators in this Thesis is also suitable for all the other processes in health care.
Secondary keywords:	Quality in healthcare;Quality indicators;Quality indicators in healthcare;FMEA method;
URN:	URN:SI:UM:
Type (COBISS):	Master's thesis/paper
Thesis comment:	Univ. v Mariboru, Fak. za organizacijske vede
Pages:	88 f.
ID:	10852720