Dealing with risks in patient care
Quality management
Godehard Winter
Leitbild- und Qualitätsmanagement-Beauftragter
Neustraße 1
59348 Lüdinghausen
Phone:
02591
-231-464
Mail:
ed.nesuahgnideul-hms@retniw.drahedog
Direktorium, QM
Conference frequency: monatlich
Risk management
Godehard Winter
Leitbild- und Qualitätsmanagement-Beauftragter
Neustraße 1
59348 Lüdinghausen
Phone:
02591
-231-464
Fax: 02591-464-341
Mail:
ed.nesuahgnideul-hms@retniw.drahedog
Direktorium, QM
Conference frequency: monatlich
Risk management instruments and measures
| No. | Explanation |
|---|---|
| RM01 |
Comprehensive quality and/or risk management documentation (QM/RM documentation) is available Risikomanagement Konzept (06.12.2021) |
| RM02 |
Regular further education and training measures |
| RM03 |
Employee surveys |
| RM04 |
Clinical emergency management Internes Notfallmanagement (05.04.2022) |
| RM05 |
Pain management Handbuch Schmerztherapie (25.04.2018) |
| RM06 |
Fall prophylaxis Sturzpropylaxe in der Pflege (15.05.2020) |
| RM07 |
Use of a standardised concept for pressure ulcer prophylaxis (e.g. “Expert Standard for Pressure Ulcer Prophylaxis in Nursing”) Dekubitus-Prophylaxe (23.02.2023) |
| RM08 |
Regulated handling of custodial measures Verfahrensanweisung Fixierung (18.09.2023) |
| RM09 |
Regulated handling of occurring malfunctions of devices Produktrückruf - Produktmitteilung (10.12.2021) |
| RM10 |
Structured implementation of interdisciplinary case discussions/conferences Case review conference
|
| 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 Bestandteil der OP-Checkliste (07.11.2018) |
| RM15 |
Preoperative, complete presentation of necessary findings OP-Checkliste (07.11.2018) |
| RM16 |
Procedure to avoid procedural and patient mix-ups Handbuch Chirurgie (25.06.2018) |
| RM17 |
Standards for recovery and postoperative care ?? (01.01.2022) |
Fault reporting systems
Conference committee
Conference frequency: bei Bedarf
Measures
z. B. Schulungen zu Medikamentenanwendung, Fortbildungen zu Dekubitusprophylaxe und Harninkontinenz,
| No. | Explanation |
|---|---|
| IF01 |
Documentation and procedural instructions for handling the error reporting system are available As of: 06.10.2020 |
| IF02 |
Internal evaluation of the received reports taken bei Bedarf |
| 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: quartalsweise
| No. | Explanation |
|---|---|
| EF06 |
CIRS NRW (North Rhine and Westphalia-Lippe Medical Associations, North Rhine-Westphalia Hospital Association, North Rhine and Westphalia-Lippe Associations of Statutory Health Insurance Physicians, German Medical Association) |