Research On The Risk Management During International Medical Rescue Based On Risk Assessment Model In Field Hospitals

Objective: The field hospital risk assessment model was established based on the construction of risk assessment index system in field hospitals,and combination of analytic hierarchy process(AHP)and risk matrix methods,and the overall risk level in field hospitals was ultimately determined after comprehensive assessment of the risk in order to provide scientific basis for risk management decisions during international medical rescue in field hospitals.Methods :1 The risk assessment experts group was set up for field hospitals from research consultants using Delphi method,combined with random sampling principle of mathematical statistics and the actual situation in this study.2 Construction of risk assessment system: The risk assessment index system was established by retrieving literature data,reviewing "Peace Angel-2009" medical rescue of Bethune International Peace Hospital,collecting relevant data and consulting experts with practical experiences of medical rescue,and then the feasibility of the system was preliminarily consulted to experts during international medical rescue in field hospital.On this basis,in order to make the dispersed views gradually converging,different opinions of experts were summarized and organized repeatedly using the Delphi method,and the dispersed views were gradually converged.The evaluation indexes were confirmed combined with the statistical results of important index scores.3 Confirming the risk classes: The quantitative analysis for risk factors was analyzed using risk matrix method combined with risk assessment system.The experts evaluated risk possibility and severity of the risk classes based on the risk quantification table,and then the Borda values of all risks were achieved and sorted using Borda sequence value analysis method to determine the Borda ordered values of risk factors.4 Confirming of risk weight: In the third round of expert consultation,AHP was applied for determining the risk factor weights in field hospitals.A hierarchy model was built according to the AHP principle combined with risk assessment index system.The pairwise comparisons was performed by experts using 1 to 9 scale method,and then pairwise judgement matrix was established.The consistency indexes were used to judge consistency test for matrix,and then the index weights in the judgment matrix were obtained when judgement matrix satisfied the judgment matrix consistency.5 Building the risk assessment model: According to the implementation process of the risk assessment,the risk assessment model for field hospitals was constructed on the basis of a comprehensive analysis of risk factors combined with the principle and characteristics of risk matrix method and AHP.6 Evaluating the risk classes in field hospitals: Integrated with the weight and risk class of each risk factor,the overall risk level of field hospitals was ultimately determined by accumulating the product of risk value and the corresponding risk weight of each risk factor.Results:1 A expert group of 15 people was set up,and the risk assessment index system of field hospitals was also established.The system consisted 1 target layer,9 criterion layers and 49 index layers.The authority coefficient value of experts was 0.883,which indicated that the result was credible.2 Results of the class and weight of risk factors: The risk class of risk possibility and severity of the consequences were judged by risk matrix method,and the values and classes of risk factors in field hospitals were determined.Risk value was relative concentrated and high,most of the risk level reached class ?.The results of the judgment matrix consistency test met the consistency(CR<0.1),and the weight distribution of risk factors was obtained.3 Construction of the risk matrix model: The risk matrix table was constructed on basis of the risk possibility,class of the consequence severity,risk class,the Borda sequence value and risk weight judged by experts group.Managers should pay high attention to medical treatment and rescue capability,quality of care and safety management,logistic support,disease outbreaks,nosocomial infection,personnel management,communication facilities and so on,which need to be strengthened risk management.4 Result of the building risk assessment model: On the basis of the implementation process of the risk assessment,the risk assessment model for field hospitals was established.Evaluation of the risk class in field hospitals was the model goal,and risk matrix and AHP methods worked as the model basis.It included risk identification,risk analysis and risk evaluation.The research calculated levels and weight of each risk factor quantitatively,and finally obtained the field hospital risk value by risk matrix,which realized the transformation from qualitative analysis to quantitative analysis.5 The risk class of field hospitals was class ?(RT=11.5592),which belonged to the significant risk range,so the intolerable risk class should be paid more attention.Conclusion:The risk assessment model is constructed using AHP combined with risk matrix methods,and therefore the dynamic risk management for field hospitals can be achieved,which may provide ideas for hospital risk management.