Dealing with risks in patient care

Quality management

Dipl.-Chem. Frank Höhne

Standortverantwortlicher Qualitätsmanager

Schleusinger Str. 17
98646 Hildburghausen

Phone: 03685 -773-207
Mail: ed.nekinilk-demoiger@enheoh.knarf

Vertreter aller Abteilungen

Conference frequency: halbjährlich

Risk management

Andreas Flemming

Risikomanager

Schleusinger Str. 17
98646 Hildburghausen

Phone: 09561 -9733-2216
Mail: ed.nekinilk-demoiger@gnimmelf.saerdna

Conference frequency:

Risk management instruments and measures

No. Explanation
RM01

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

QM-Dokumentation (31.12.2018)

RM02

Regular further education and training measures

RM03

Employee surveys

RM04

Clinical emergency management

QM-Dokumentation (31.12.2018)

RM05

Pain management

QM-Dokumentation (31.12.2018)

RM06

Fall prophylaxis

QM-Dokumentation (31.12.2018)

RM07

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

QM-Dokumentation (31.12.2018)

RM08

Regulated handling of custodial measures

QM-Dokumentation (31.12.2018)

RM09

Regulated handling of occurring malfunctions of devices

QM-Dokumentation (31.12.2018)

RM10

Structured implementation of interdisciplinary case discussions/conferences

Case review conference

  • Tumorkonferenzen
  • Mortalitäts- und Morbiditätskonferenzen
  • 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

QM-Dokumentation (31.12.2018)

RM15

Preoperative, complete presentation of necessary findings

QM-Dokumentation (31.12.2018)

RM16

Procedure to avoid procedural and patient mix-ups

QM-Dokumentation (31.12.2018)

RM17

Standards for recovery and postoperative care

QM-Dokumentation (31.12.2018)

RM18

Discharge management

QM-Dokumentation (31.12.2018)

Fault reporting systems

Conference committee

Conference frequency: quartalsweise

Measures

CIRS

No. Explanation
IF01

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

As of: 31.12.2018

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: bei Bedarf

No. Explanation

Other

EF01

CIRS AINS (Professional Association of German Anaesthetists and German Society for Anaesthesiology and Intensive Care Medicine, German Medical Association, National Association of Statutory Health Insurance Doctors)

EF03

KH-CIRS (German Hospital Federation, Action Alliance for Patient Safety, German Nursing Council, German Medical Association, National Association of Statutory Health Insurance Doctors)

EF14

CIRS Health Care