專題討論17:手術前後風險的新思維
New Thoughts in Perioperative Risk

S17-5
麻醉安全及品質中心
Anesthesia Safety and Quality Assessment Center
吳世銓
中國醫藥大學附設醫院

  The Taiwan Anesthesia Performance Center (TAPC) is a non-profit organization dedicated for the improvement of anesthesia patient safety and quality improvement in Taiwan. In conjunct with the Anesthesia Safety and Quality Improvement Program (ASQIP), the center assists participating anesthesia departments in identifying opportunities for improvement in patient care. Initiated by the Taiwan Society of Anesthesiologists, the main goal of the program is to help its member to obtain information and statistical data for improvement. Since the announcement of the organizing plan for the center, 10 hospitals in the central district of Taiwan agreed to participates in the program.

  Using well-defined clinical and administrative indicators as the anesthesia quality indicator, the ASQIP allows participating anesthesia departments to measure their performance against both an aggregate database, as well as their own database over time. The ASQIP also provides educational training sessions for participating organization that include teaching for networking and benchmarking activities, and sharing of Mortality and Morbidity information among participating organizations.

  The ASQIP offers 20 different major indicator sets under the vicinity of anesthesia care. Each major indicator set contains multiple minor indicators that focus on different information within the category of that particular major indicator. Participants can choose whatever indicator sets which they would like to submit data. For every set of indicators the participants submitted monthly, the ASQIP return back a report within fourteen days following the end of each data collection quarter. The quarterly report shows their department’s performance over time for each selected measure, as well as how their anesthesia compares to the aggregate database (Data from all participants). In addition, a “peer group comparison reports,” which compare data among departments with similar characteristics, such as hospital size, geographic location, anesthesia volume, number of anesthesiologists, teaching status, and clinical services offered.

  As the TAPC honors confidentiality of each participant, straight protocols are followed so that the identity of the participant is not exposed to others. Each participant has password-protected access to the ASQIP website, where the data are collected and analyzed. This password-protected entry site ensures that participants do not have access to other participants’ data at anytime. For added protection, all ASQIP participants have a unique, randomly-assigned identification number instead of name of the participant’s hospital in data entry as well as on all reports. Neither the TAPC nor any sponsoring system can release participant-specific data for any reason without first obtaining written permission of the participant.

  ASQIP report is the first objective wide-scope database on anesthesia safety and quality control in Taiwan. It not only provides valuable information to participating anesthesia organization but also to the Taiwan Health Officials and may extend substantial influences on national polices for anesthesia and public health.

  The AQIP is open for sponsorship from medical industry. Donation will be applied to organizing activities of the ASQIP.