Dealing with risks in patient care

Quality management

Elena Högemann

Stabsstelle Qualitäts- und Risikomanagement

Am Krankenhaus 2
48231 Warendorf

Phone: 02581 -20-1015
Mail: ed.fawhj@nnamegeoh.e

Vorstandsvorsitzender Vorstand Ärztlicher Direktor Pflegedirektion Qualitäts- und Risikomanager

Conference frequency: halbjährlich

Risk management

Elena Högemann

Stabsstelle Qualitäts- und Risikomanagement


48206 Warendorf

Phone: 02581 -20-1015
Fax: 02581-20-1003
Mail: ed.fawhj@nnamegeoh.e

Vorstandsvorsitzender Vorstand Ärztlicher Direktor Pflegedirektion Qualitäts- und Risikomanager

Conference frequency: halbjährlich

Risk management instruments and measures

No. Explanation
RM01

Comprehensive quality and/or risk management documentation (QM/RM documentation) is available

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM02

Regular further education and training measures

RM03

Employee surveys

RM04

Clinical emergency management

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM05

Pain management

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM06

Fall prophylaxis

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM07

Use of a standardised concept for pressure ulcer prophylaxis (e.g. “Expert Standard for Pressure Ulcer Prophylaxis in Nursing”)

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM08

Regulated handling of custodial measures

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM09

Regulated handling of occurring malfunctions of devices

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM10

Structured implementation of interdisciplinary case discussions/conferences

Case review conference

  • Tumorkonferenzen
  • Mortalitäts- und Morbiditätskonferenzen
  • Pathologiebesprechungen
  • Palliativbesprechungen
  • Qualitätszirkel
RM12

Use of standardised information sheets

RM13

Application of standardised surgical check lists

RM14

Preoperative summary of predictable critical surgical steps, surgical time and expected blood loss

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM15

Preoperative, complete presentation of necessary findings

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM16

Procedure to avoid procedural and patient mix-ups

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM17

Standards for recovery and postoperative care

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

RM18

Discharge management

Zentrale digitale Dokumentenlenkung und Dokumentenmanagement (06.12.2021)

Fault reporting systems

Conference committee

Conference frequency: monatlich

Measures

Diverse Maßnahmen in den Bereichen Medikationsmanagement, Hygiene, Organisation, etc.

No. Explanation
IF01

Documentation and procedural instructions for handling the error reporting system are available

As of: 10.04.2017

IF02

Internal evaluation of the received reports

taken monatlich

IF03

Training of employees in handling the error reporting system and in implementing the findings from the error reporting system

taken bei Bedarf

Conference committee

Conference frequency: monatlich

No. Explanation
EF14

CIRS Health Care