1、婦幼醫院管理案例婦幼保健領域中醫院管理與質量控制婦幼醫院管理案例婦幼保健領域中醫院管理與質量控制 2 4 3 5The Maternity Centre 婦產中心Over 3000 babies delivered each year 年均3000新生兒68% delivered naturally, 18% Cesarean Section, 14% instrumental delivery 68% 自然分娩, 18% 剖腹產，14% 輔助分娩（使用產鉗、硬膜外等）24 hour access to advice from midwives 助產士24小時值班One to one care

2、 throughout labour 整個分娩過程1對1助產士陪伴On-site Special Baby Care unit 新生兒特需監護病房On site (adult) emergency facilities including theatre and intensive care 急救室（包括手術室和危重急救）At the Maternity Centre our aim is to facilitate a positive birth experience in a safe, sensitive, supportive and friendly environmentThe

3、Maternity Centre 婦產中心Over 5 73Person-centred 以人為本:providing care that is responsive to individual personal preferences, needs and values and assuring that patient values guide all clinical decisions響應患者個人偏好、需求和價值觀來提供醫療服務，確保臨床決策尊重患者意愿Timely 適時:reducing waits and sometimes harmful delays for both thos

4、e who receive care and those who give care.不管是對患者，還是醫院工作者而言，盡量減少等待和傷害性延誤Efficient 高效:avoiding waste, including waste of equipment, supplies, ideas, and energy;避免包括設備、物資、理念和精力等資源的浪費Safe 安全:avoiding injuries to patients from healthcare that is intended to help them避免在醫療過程中對患者造成傷害Effective 效果:providing

5、 services based on scientific knowledge基于科學知識提供服務Equitable 公平:providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socio-economic status所提供的醫療服務質量不因個人特征如性別、種族、地理定位或社會經濟地位不同而改變Quality in Care 醫療質量Quality in Care醫療質量3Person-

6、centred 以人為本:Timely 適Clinical and Risk Management Effectiveness臨床和風險管理效力Safe and Effective安全和有效Set evidence based standards coupled with robust check to ensure adherence to standards through: 通過以下方式制定循證標準及穩健的檢查以確保遵守標準： Encouraging incident reporting 鼓勵事故報告 Investigating and learning from variances 從

7、差異中研究和學習 Carrying out maternal and perinatal death reviews 實施孕產婦及圍產期死亡審查 Undertaking clinical audits 著手臨床審計 Design and change systems with the patient and her family in mind 與患者和患者家屬設計和更改系統Clinical and Risk Management EPerinatal Death Reviews圍產期死亡審查Many perinatal deaths are preventable. Well impleme

8、nted death reviews provide opportunities to examine the circumstances surrounding a childs death, and improve the delivery of health services to prevent such deaths in the future.許多圍產期死亡事件是可以預防的，負責任地落實死亡審查，檢查死亡嬰兒周圍環境，能夠幫助預防未來可能發生類似情形的死亡。The BirminghamReducingPerinatalMortality Project (Martin and Ga

9、rdosi 2007) aims to increase to 60%, detection rates of growth restricted fetuses through a programme ofenhanced community care, including useofcustomised fetal growth charts and training and accreditation ofclinicalassessmentoffetalgrowth using a tape measure.伯明翰降低圍產期死亡率項目（Martin and Gardosi 2007）

10、旨在通過加強社區護理計劃，使用定制胎兒生長圖表、制定標準培訓、認證胎兒生長的臨床評估,將胎兒增長限制的檢出率提升至60%。Perinatal Death Reviews圍產期死亡審Patient Experience and Communication Effectiveness患者體驗和溝通效果Equitable and Person Centred公平與以人為本Ensure and confirm that you are providing care that is acceptable to the woman by: 通過以下方式確保并確認能為孕產婦提供可接受的護理： Invitin

11、g feedback at the point of patient care 從患者護理中獲取患者反饋 Undertake care observation 做患者保健觀察 Investigate and learn from patient complaints and feedback 從患者投訴和反饋中研究和學習 Investigate and learn from incidents 從突發事件中研究和學習 Communicate effectively providing verbal and written information 從有效溝通中獲取口頭和書面信息Patient E

12、xperience and Communi 10 12 11 13 12 14 13 15Learning from Patient Complaints and Feedback從患者投訴和反饋中學習Our families asked for their husbands and partners to stay with them overnight to help with the care of the baby. We have set up a process to enable that to happen為了方便照顧新生兒，家屬要求丈夫和伴護夜里也能夠和她們待在一起。我們已經

13、設立了相關程序，希望可以滿足這一要求。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 building the new room with input from women who lost their babies. 一些胎兒出生便死亡的家庭投訴稱他們所處的病房太小或者離胎兒出生存

14、活的孕產婦病房太近。我們正在為那些失去自己孩子的產婦單獨建設新的房間。Learning from Patient ComplaiResource and Strategic Effectiveness資源和戰略性的效率Efficient and Timely高效和適時Ensure that you are providing care that is timely and efficient by:通過以下方式確保所提供的護理是適時和高效的： Providing care close to home 為患者住家所在地附近提供可及護理 Delivered according to timetab

15、led standards 根據時間表標準提供醫療服務 Providing clinics with all the professionals required to provide the correct one stop care i.e. Obesity Clinics, Diabetic Clinics 為門診提供所需的所有能夠提供正確的“一站式”護理的專業人員：如肥胖癥門診和糖尿病門診 Monitor waiting lists 監控患者等候名單 Monitor cost effectiveness 監控成本效益.Resource and Strategic Effecti 16

16、18 17Chair 椅子Hysterescopy宮腔鏡Digital Screen電子屏幕Colposcopy 陰道鏡Ultrasound超聲檢查RecoveryRoom病人休息室En-suite 衛生間、淋浴室PC & Desk辦公桌、電腦椅子椅子洗手池One Stop Out-paitent Clinic in Gynecology婦科一站式門診（All in one room， 全部在一個房間內 ）門 19ChairHysterescopyDigital S 18One Stop Out-paitent Clinic in Gynecology婦科一站式門診（All in one ro

17、om， 全部在一個房間內 ）Colposcopy (陰道鏡)Hysterescopy (宮腔鏡)Early pregnancy clinic (妊娠早期門診)Suspected cancer clinic (疑似癌癥診斷門診)Sterilization clinic (絕育手術)Bladder Bulking Agent Injection (膀胱膨脹劑注射)Endometrial Ablation Clinic (子宮內膜切除手術) 20One Stop Out-paitent Clini Performance oversight 績效監督Consistent oversight and

18、performance 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 e

19、scalation and 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.通過信托一致性監管和績效框架確保服務的質量和可持續性；月度部門績效要與女性健康部門要求符合，針對國家和本地產科質量四重奏標準來監管績

20、效；為升職、高難度領域的支持或表現不佳定義相關標準；包括明確升職進入執行委員會的路線；部門由專門的財務和人力資源業務伙伴來支持管理；將績效和項目管理辦公室團隊集中化 Performance oversi Obstetrics Quality Quartet產科質量四個模塊 Obstetrics QualityStaff and leadership員工和領導Staff 員工Engage the staff 員工參與Communicate and Inform溝通和知情Support frontline innovation 支持前沿創新Support the staff at all times無論何時都支持員工 Educate for the work and for themselves針對員工工作和個人發展展開教育Appraisal 評估Leadership 領導Inspire shared purpose 鼓勵共享的目的Lead with Care 領導與關懷Evaluate information 評估信息Connect Servces 聯系服務Share Vision 共享視角Engage with the Team 和團隊融為一體Hold to Account 承擔責任Develop