ISQUA17-1379A CLINICAL RISK MANAGEMENT SYSTEM(CRMS) BASED IP-SDM CARE MODEL IN GENERAL HOSPITAL

Abstract

Objectives: For an interprofessional approach to shared decision making (IP-SDM), two or more professionals collaborate with patient in identifying best options, clarifying patient preferences and enabling patients to take more control over treatment plan. High-quality and cost-effective healthcare service are seen as two key elements in interprofessional care and the engagement of patients as partners in their own care. However, the high cost, time consuming and poor efficiency of IP-SDM model makes that IP-SDM is not routinely implemented in clinical practice and effective.Clinical Risk Management System(CRMS) is an approach to identify the clinical risk for inhospital patients and relocates the medical resource to the high-risk patients. CRMS-based IP-SDM model can be implemented in general hospital systemically and efficiently. However, little is known about the satisfaction of the medical professionals while implementing CRMSbased IP-SDM systemically in a general hospital. Methods: We evaluated the healthcare professionals, patients and their families who engaged in CRMS-based IP-SDM since 2011 to 2013. A total 153 doctors and nurses and 341 patients and their families completed a questionnaire based on the theory of satisfaction. The performance information of hospital also was collected since 2010 to 2013 to compare the related factors before and after implementing CRMS-based IP-SDM. Results: Since 2010 to 2013, the number of admitted patients increased 9.7% and Case-Mixed Index for disease severity is no difference. After implementing CRMS-based IP-SDM, the medical malpractice cases reduced 74%. To engage in medical care team and participate clinical decision discussion get the highest scores in patients' and families' satisfaction evaluation. To improve the communication among medical professionals, (Figure Presented) to resolve the clinical problems efficiency, and to improve patients safety in practical way was more concerned in healthcare professionals. Conclusion: Implementing CRMS-based IP-SDM in general hospital can create a more safe, cost-effective and medical professionals satisfied environment. The cooperation among medical professionals and the engagement of patients as partners need to be supported by a new medical care system which can balance the care quality, hospital performance and patient safety.