利用資料包絡分析強化FMECA於病人用藥安全之風險評估

Applying data envelopment analysis to enhance risk assessment capability of FMECA for patient medication safety

葉俐廷(Li-Ting Yeh) ； 張東生(Dong-Shang Chang) ； 邱慧珍(Huey-Jen Chiou)

《健康管理學刊》 13卷1期 (2015/06) Pp. 52-62

摘要

如何確保病人用藥安全已成為醫療照護品質管理的重要議題。失效模式影響與關鍵性分析(Failure Mode Effects and Criticality Analysis；FMECA)常用於評估醫療系統運作過程中潛在的風險，此外，透過FMECA 可以預防醫療過失的發生。然而，目前失效模式影響與關鍵性分析有一些缺點。為解決這個缺點，本研究嘗試藉由結合FMECA與資料包絡分析之SBM (Slack-Based Measure)模式，將每個失效模式視為SBM模式中的決策單位，而FMECA 的三項風險指標視為投入項。為驗證該方法的有效性和實用性，本研究以小兒科使用腸胃外營養溶液過程為案例。這個方法可強化FMECA 的評估能力，並且提供改善風險的資訊進而減少醫療失效發生。

關鍵字

病人安全 ； 藥物過失 ； 失效模式影響與關鍵性分析 ； 資料包絡分析

並列摘要

Ensuring patient medication safety has become critical in the field of health care quality management. In healthcare system, the failure mode effects and criticality analysis (FMECA) is commonly used to assess the potential degree of risk. Employing FMECA can reduce the occurrence of medical errors. However, there are some shortcomings in FMECA. This paper addresses these shortcomings by integrating FMECA and data envelopment analysis with slack-based measure (SBM) model. Each failure mode used in FMECA is regarded as a decision making unit in SBM model. And the three risk indexes of FMECA are viewed as inputs of SBM model. The usefulness and practicality of the proposed approach is illustrated by one case of health care, a case study of the process of producing paediatric parenteral nutrition formulations. Using this approach can enhance the assessment capabilities of FMECA and offer corrective information of risk to reduce thereafter the possibility of health care failure.

並列關鍵字

patient’s safety ； medication error ； failure mode effects and criticality analysis ； data envelopment analysis