HFMEA模式在急诊行经皮冠脉介入治疗患者转运交接中的效果评价

 目的 探究医疗失效模式与效应分析（healthcare failure mode and effect analysis,HFMEA）在急诊行经皮冠脉介入治疗（percutaneous coronary intervention,PCI）患者转运交接中的应用效果。方法 选择2019年10月至2020年3月行急诊PCI的62例患者为对照组,2020年4月至2020年9月行急诊PCI的62例患者为试验组。对照组采用常规的PCI转运交接模式;试验组采用HFMEA模式,通过组建转运交接小组、对转运流程进行前瞻性分析、识别潜在的风险因素、制定优化方案。比较两组患者平均转运交接时间、D-to-B平均时间、转运不良事件发生率、患者及接受科室满意度。结果 试验组患者平均转运交接时间、D-to-B平均时间明显短于对照组,差异具有统计学意义（P<0.05）;试验组中与病情变化、转运设备、转运过程相关的不良事件发生率显著低于对照组,组间比较差异具有统计学意义（P<0.05）;试验组患者满意度总分及接受科室满意度总分均明显高于对照组,差异具有统计学意义（P<0.05）。结论 通过应用HFMEA模式优化急诊PCI患者转运交接流程,可以有效缩短转运时间和D-to-B时间、降低转运不良事件的发生率、提高患者及接受科室的满意度。

Effectiveness evaluation of the healthcare failure mode and effect analysis (HFMEA) in the transportation of emergency patients with percutaneous coronary intervention

Objective To explore the effect of the healthcare failure mode and effect analysis(HFMEA) for transportation of emergeney patients with percutaneous coronary intervention (PCI). Methods Sixty-two patients from Oct 2019 to Mar 2020 were recruited in the control group, while the other 62 patients from Apr to Sept 2020 were recruited in the test group. Patients in the control group was implemented the routine for PCI transportation, and patients in the test group was implemented the improved transportation based on HFMEA. The average time for transportation and D-to-B, the incidence of the adverse events during the transportation and satisfaction of the patient and the accepted department between the two groups were compared. Results The average time for transportation and D-to-B in the test group was shorter than that in the control group (P<0.05). The incidence of the adverse events which correlated with the change of illness, the facilities and the process during the transportation in the test group were lower than that in the control group (P<0.05). The satisfaction of the patient and the receiving department in the test group was higher than that in the control group (P<0.05). Conclusion Applying the HFMEA mode for the patients with PCI could shorten the average time for transportation and D-to-B, decrease the incidence of adverse events during the transportation and improve the satisfaction of patient and receiving department.