Evidence-Based Evaluation of Medical Risk Management System in UK and Its Application to Medical Risk Management in China_Chinese Journal of Evidence-Based Medicine

Authors：

MA Bin ¹ ,  YANG Kehu ¹ , LIU Yali ¹ , TIAN Jinhui ¹ , ZHANG Zhongnan ¹ , LI Youping ² , Wang li ² , XU Li ³ , CAO Xiaoyuan ³ , TENG Yongjun ⁴ , WANG Yu ⁵ , ZHANG Zongjiu ⁵ , ZHAO Minggang ⁵ , LU Jun ⁶ , LIU Qilin ⁶

1. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China 2. Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, Chengdu 610041, China 3. Health Department, GanSu Province, Lanzhou 730000, China 4. First hospital of Lanzhou University, Lanzhou 730000, China 5. Department of Medical Administration, Ministry of Health, Beijing 1000441, China 6. Chinese Medical Doctor Association, Beijing 100711, China;

Corresponding author：

YANG Kehu, Email: yangkh2006@163.com

Keywords：

Medical risk; Risk management; Medical error; Patient safety; UK

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To analyze experiences of medical risk management in the United Kingdom so as to explore the possible application for the construction of a Chinese medical risk monitoring and early warning system.
Methods 　We searched Engineering Information, SCI and SSCI, EMBASE, SCOPUS with 100% MEDLINE, VIP, CNKI, and government or official websites. This search was conducted in Jan. 2006. We included articles about medical risk, patient safety and medical errors in the UK. Languages of articles were limited either in English or in Chinese.
Results 　Eleven articles were included, of which 9 article are evidence of level B (about 80%) and the other 2 are evidence of level C (about 20%). The report of “An Organization with a Memory” revealed the severity of medical errors and adverse events in the UK in 2000, and subsequently Minister Blair announced a five-year reform program for NHS. Within 7 years of reform, NHS budget has been increased from £33 billion to £674 billion,(check numbers-doesn’t sound correct) the National Patient Safety Agency (NPSA) and the New National System for learning from adverse events and near misses have been established, a series of practicable measures aimed at ensuring patient safety, preventing medical risk and improving healthcare quality have been implemented, all of which have effectively resolved many problems that perplexed the government and public, such as patients waiting time, range of NHS service, the availability of medical facility and mortality induced by high-risk diseases.
Conclusion 　There are both advantages and disadvantages in the present status of the UK medical risk management. Both of them will provide a guide to prevent medical risk, improve healthcare quality and to realize the ultimate goal that everybody could share healthcare sources fairly and safely in our country.

Citation： MA Bin,YANG Kehu,LIU Yali,TIAN Jinhui,ZHANG Zhongnan,LI Youping,Wang li,XU Li,CAO Xiaoyuan,TENG Yongjun,WANG Yu,ZHANG Zongjiu,ZHAO Minggang,LU Jun,LIU Qilin. Evidence-Based Evaluation of Medical Risk Management System in UK and Its Application to Medical Risk Management in China. Chinese Journal of Evidence-Based Medicine, 2006, 06(7): 514-522. doi: Copy

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1. 福利国家能否守住自己的“良心”？Available from URL: http://www.people.com.cn/GB/guandian/183/6103/7942/2286805.html.
2. 杨克虎, 马彬, 田金徽, 等. 美国医疗风险监测预警机制现状及绩效的循证评价. 中国循证医学杂志, 2006; 6(6): 439～450.
3. 英国医疗保障制度变迁及其启示. Available from URL: http://www.china-insurance.com/news-center/newslist.asp?id=79122.
4. Whether Welfare country can defends themselves the conscience or not? Available from URL: http://www.people.com.cn/GB/guandian/183/6103/7942/2286805.html.
5. Towse A. Danzon P. Medical negligence and the NHS: An economic analysis. Health Economics, 1999; 8(2): 93-101.
6. An Organisation with a Memory. Report of an Expert Group on Learning from Adverse Events in the NHS Chaired by Chief Medical Officer. Department of Health. 2000. Available from URL: http://www.dh.gov.uk/assetRoot/04/06/50/86/04065086.pdf.
7. Health Care in Canada: The Canadian Institute for Health Information. 9 June 2004.
8. Available from URL: http://www.npsa.nhs.uk/.
9. Building a Safer NHS for Patients: Implementing an organisation with a memory. Department of Health. 2001. Available from URL: http://www.dh.gov.uk/assetRoot/04/05/80/94/04058094.pdf.
10. Yang KH, Ma B, Tian JH, et al. Evidence-based evaluation of American medical risk monitoring and precaution system. Chin J Evid.-based Med, 2006; 6(6): 439-450.
11. Next Step Towards Creating a Safer NHS. Department of Health, Friday 3 August 2001. Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4010827&chk=TzeZXg.
12. Smith G. Assesses the Patient Safety Challenges in the year ahead: NPSA annual review 2004-2005. The National Patient Safety Agency.
13. Chief Executive’s Report to the NHS. Department of Health, December 2005. Available from URL: http://www.dh.gov.uk/assetRoot/04/12/43/02/04124302.pdf.
14. The NHS Improvement Plan: Putting People at the Heart of Public Services. (Executive Summary) Department of Health 2004. Available from URL:http://www.dh.gov.uk/assetRoot/04/08/45/23/04084523.pdf.
15. Hunt LP. Health Minister announces new guidance to reduce medication errors. Department of Health, 3 March 2003.
16. Building a Safer NHS for Patients: Improving Medication Safety. A report by the Chief Pharmaceutical Officer, 2004. Available from URL:http://www.dh.gov.uk/assetRoot/04/08/49/61/04084961.pdf.
17. Ashcroft DM, Quinlan P. Prospective study of the incidence, nature and causes of dispensing errors in community pharmacies. Pharmacoepidemiology and Drug Safety, 2005; 14(5): 327-332.
18. The Quality Interagency Coordination Task Force (QuIC). Doing what counts for patient safety: federal actions to reduce medical errors and their impact (report to the president). February 2000. Available from: URL: http://www.quic.gov/report/errors6.pdf.
19. Tilyard M, Dovey S, Hall K. Avoiding and fixing medical errors in general practice: prevention strategies reported in the Linnaeus Collaboration’s Primary Care International Study of Medical Errors. N Z Med J, 2005; 118(1208): U1264.
20. English medical service safeguard system vicissitude and inspires. Available from: URL: http://www.china-insurance.com/news-center/newslist.asp?id=79122.
21. Public’s priorities are NHS plan priorities. 19 February 2002. Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4013077&chk=ouE2AM.
22. New equality champion for the NHS. 13 October 2004 .Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4091141&chk=nHKml/.
23. £8m to develop NHS innovations 1 February 2006. Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4127569&chk=izyp3P.
24. Donaldson L. NHS blame culture is still a killer. 25 March 2005.
25. Available from URL:http://news3.xinhuanet.com/politics/2006-03/18/content_4317180.htm.
26. Investing in primary care: outline of the scheme. Available from: URL: http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/PrimaryCare/InvestingInPrimaryCare/InvestingInPrimaryCareArticle/fs/en?CONTENT_ID=4000560&chk=2gK5tH.
27. Baker R, Norton P, Brown AD. Governments and Patient Safety in Australia, the United Kingdom and the United States: A Review of Policies, Institutional and Funding Frameworks, and Current Initiatives: Final Report, August 2002.
28. World Health Organization. The World Health Report 2005. Available from URL: http://www. who.int/countries/gbr/en/index.html.

Chinese Journal of Evidence-Based Medicine

Evidence-Based Evaluation of Medical Risk Management System in UK and Its Application to Medical Risk Management in China

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