Dealing with risks in patient care
Quality management
M.A: Management für Gesundheits- und Sozialeinrichtungen Marianne Stübbe
Leitung Allgemeines Qualitätsmanagement
Vinzenz Straße 6
46414 Rhede
Phone:
02561
-99-1265
Mail:
ed.lmwk@ebbeuts.ennairam
Mitglieder der KBL, QM, Vertreter aus den Abteilungen/ Funktionsbereichen
Conference frequency: quartalsweise
Risk management
Marianne Stübbe
Leitung Allgemeines Qualitätsmanagement
Phone:
02561
-99-1265
Fax: 02561-99-1706
Mail:
ed.lmwk@ebbeuts.ennairam
Mitglieder der KBL, QM- Vertreter aus den Abteilungen/ Funktionsbereichen
Conference frequency: quartalsweise
Risk management instruments and measures
| No. | Explanation |
|---|---|
| RM01 |
Comprehensive quality and/or risk management documentation (QM/RM documentation) is available Teil der QM/RM- Dokumentation (31.12.2021) |
| RM02 |
Regular further education and training measures |
| RM04 |
Clinical emergency management Teil der QM/RM- Dokumentation (31.12.2021) |
| RM06 |
Fall prophylaxis Teil der QM/RM- Dokumentation (31.12.2021) |
| RM07 |
Use of a standardised concept for pressure ulcer prophylaxis (e.g. “Expert Standard for Pressure Ulcer Prophylaxis in Nursing”) Teil der QM/RM- Dokumentation (31.12.2021) |
| RM08 |
Regulated handling of custodial measures Teil der QM/RM- Dokumentation (31.12.2021) |
| RM09 |
Regulated handling of occurring malfunctions of devices Teil der QM/RM- Dokumentation (31.12.2021) |
| RM10 |
Structured implementation of interdisciplinary case discussions/conferences Case review conference
|
| RM12 |
Use of standardised information sheets |
| RM18 |
Discharge management Teil der QM/RM- Dokumentation (31.12.2021) |
Fault reporting systems
Conference committee
Conference frequency: quartalsweise
Measures
Maßnahmen zur Patientensicherheit, zur Mitarbeitersicherheit; somatisches Notfallmanagement, Optimierung der elektiven Aufnahme; Maßnahmen zur Patientenkommunikation; Maßnahmen zur Außenwirkung
| No. | Explanation |
|---|---|
| IF01 |
Documentation and procedural instructions for handling the error reporting system are available As of: 31.12.2022 |
| 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 halbjährlich |
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) |