ASOURCE Times

Actively work to improve work efficiency

St. Luke's International Hospital has a history of 117 years and is a large hospital with 520 inpatient beds.
As the director, I am responsible for Financial Health and Patient Health, and I am working on the reform of the hospital every day.
Regarding Financial Health, hospitals earn income and operate within the medical fee system established by the government. For this reason, we consider whether the facility standards and additional conditions are met in the medical fee items every year, and strive to ensure that medical fees are obtained.

We are also actively working to improve work efficiency. Since 2015, we have introduced an article management system that can centrally manage more than 700 medical devices used in 17 major wards in real time. By sharing the storage status of equipment such as infusion pumps, nurses can simply take it out of the storage location when needed, without worrying about inventory, and go to the clinical engineering room or in another ward. You no longer have to search for equipment. In addition, it is possible to grasp the required number in real time from the usage status of the equipment, reduce excess inventory, and contribute to the reduction of purchase price and the efficiency of maintenance.

In addition, we have devised a system to diligently turn off the lights in unused conference rooms, which leads to cost reduction. We meet once a month with the top management of all medical departments (doctors, nurses) to discuss changes in the number of inpatients and outpatients, profits, incidents / accidents, QI indicators, etc. up to the previous month.

Hand hygiene implementation rate is 70% or more

Efforts for Patient Health are centered on QI activities that utilize electronic medical record data. QI evaluates the quality of medical care in three aspects: structure (facility, equipment, medical equipment), process (medical content / process provided to patients), and outcome (result of providing medical care) related to various medical treatments. , It is a quantified index. We are currently continuously measuring over 100 QIs.

For example, hand hygiene, in which hands are washed with a disinfectant before and after entering a hospital room, is positioned as a basic and important preventive measure against medical-related infections. We have set a target value of 80% for hand hygiene implementation rate, and since 2013, we have installed a small camera on the ceiling of the ward and have been monitoring by direct observation method. As a result, the implementation rate increased from 53% in 2011 to 74% in 2016.

Regarding the treatment of diabetes, efforts such as providing data such as the percentage of patients whose HbA1c is controlled to less than 7.0% and the type of prescription drug and individually instructing improvement have been successful.

A QI committee is held every month to discuss the movement of the numerical values of each index and efforts for improvement, and to run the PDCA cycle. Efforts to improve the quality of medical care using QI have been taken up as a subsidized project by the Ministry of Health, Labor and Welfare, and are now considered to be implemented in about 800 hospitals in Japan.

The director takes the initiative in responding to patient complaints

Every morning, an "opinion response meeting" is held under the chairmanship of the director with the participation of the person in charge of the patient service section and the patient consultation desk, the nursing department, and the staff of the medical department. We are trying to share information on requests and complaints from patients the next day. We respond promptly to requests and complaints and provide prompt feedback. Partly because of this, in a recent questionnaire survey of patients, 52% answered that they were "very satisfied" and 45% answered that they were "satisfied" ("very satisfied" and "satisfied" totaling 97%).

Our hospital acquired JCI (Joint Commision International) certification in 2012, 2015 and 2018, which is a proof of international standard medical quality and safety. As for medical safety measures, we ask nurses and doctors to submit reports on incidents and accidents, and every morning, with the attendance of the staff of the Medical Safety Management Office and the deputy director in charge, we consider measures to prevent recurrence under the supervision of the director. , We are responding as soon as possible so as not to develop into a big accident.

Recently, there have been a series of reports of cases in which it was too late for cancer patients to receive appropriate treatment because doctors overlooked laboratory findings such as CT and information could not be shared among doctors. In order to prevent such cases, we have been issuing a pathological report for malignant tumors for 7 years, and then we have received the pathological report and managed medical information to determine whether or not any medical action was taken. We have established a system in which a scholar checks electronic medical records. A similar check system is being put in place for image reports such as CT.

In addition, we have established a medical care system for patients of foreign nationality from early on with an eye on globalization. Currently, 5% of patients in our hospital, both inpatient and outpatient, are foreign nationals. With the Tokyo Olympics and Paralympics ahead, the role of this hospital is expected to grow, and I would like to continue to consider the role and ideal of St. Luke's International Hospital in the world.