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目的探讨失效模式与影响分析(failure mode and effects analysis,FMEA)在医疗机构传染病报告管理工作中的应用,建立一套适合各级各类医疗机构传染病疫情报告和管理体系的FMEA模式。方法利用FMEA原理制定分析表和调查表,选择杭州市上城区18家各级各类医院,进行传染病疫情报告与管理工作现状调查。结果建立FMEA分析表,得出17个流程环节对传染病疫情报告和管理有较大影响,省市级医院的风险等级均要低于民营医院和区级医院,民营医院风险等级最高,差异有统计学意义(H=14.332,P<0.01)。结论 FMEA模式运用于医疗机构传染病疫情报告与管理风险研究是有效的,值得在医疗风险研究中推广应用。根据FMEA分析表,可以作为判定影响传染病疫情报告和管理的重要环节依据,并制定相应措施及方案。
Objective To explore the application of failure mode and effects analysis (FMEA) in the management of infectious diseases in medical institutions and to establish a FMEA model suitable for reporting and management of infectious diseases in all kinds of medical institutions at all levels. Methods The FMEA principle was used to make analysis tables and questionnaires. 18 hospitals at all levels in Shangcheng District of Hangzhou were selected to carry out a survey on the status of the reporting and management of infectious diseases. Results The establishment of FMEA analysis table shows that 17 processes have a greater impact on the reporting and management of infectious diseases, the risk level of provincial and municipal hospitals are lower than the private hospitals and district hospitals, the highest level of risk in private hospitals, the difference is Statistical significance (H = 14.332, P <0.01). Conclusion It is effective to apply FMEA model to the study of epidemiological report and management risk of infectious diseases in medical institutions and it is worth to apply it in the study of medical risk. According to the FMEA analysis table, it can be used as an important basis for judging and influencing the reporting and management of epidemic situation of infectious diseases, and corresponding measures and programs are formulated.