Dealing with risks in patient care

Quality management

Dr. D. Albrecht

Ärztlicher Leiter

Listplatz 1
72764 Reutlingen

Phone: 07121 -2135-0
Mail: ed.kinilk-uabneznirpnork@maet

Ärzte, leitende MFA (QMB), Stationsleitung (QMB)

Conference frequency: quartalsweise

Risk management

D. Albrecht

Ärztlicher Leiter

Phone: 07121 -2135-0
Fax: 07121-3125-0
Mail: ed.kinilk-uabneznirpnork@maet

Ärzte, leitende MFA (QMB), Stationsleitung (QMB)

Conference frequency: quartalsweise

Risk management instruments and measures

No. Explanation
RM01

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

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM02

Regular further education and training measures

RM03

Employee surveys

RM04

Clinical emergency management

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM05

Pain management

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM06

Fall prophylaxis

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM07

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

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM08

Regulated handling of custodial measures

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM09

Regulated handling of occurring malfunctions of devices

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM10

Structured implementation of interdisciplinary case discussions/conferences

Case review conference

  • 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

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM15

Preoperative, complete presentation of necessary findings

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM16

Procedure to avoid procedural and patient mix-ups

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM17

Standards for recovery and postoperative care

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

RM18

Discharge management

Qualitäts- und Risikomanagement-Handbuch (30.04.2018)

Fault reporting systems

Conference committee

Conference frequency: halbjährlich

Measures

Einhaltung der Infektionshygiene nach §§23 u. 36 Infektionsschutzgesetz; Checklisten und Verfahrensanweisungen zur Instrumentenhygiene, hygienischen Flächenreinigung; Infektionsschutz Personal, Maßnahmen nach Stichverletzungen etc. im Rahmen des Qualitätsmanagements (QM).

No. Explanation
IF01

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

As of: 08.01.2017

IF02

Internal evaluation of the received reports

taken halbjährlich

IF03

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

taken halbjährlich

Conference committee

Conference frequency: