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Occupational health and safety management in polish enterprises implementing total quality management systems.

Total Quality Management (TQM) is defined as the management approach of the organization aimed at long-term success through client satisfaction, and which benefits all members of the organization and society (ISO 8402; International Organization for Standardization, 1994a). The objective of the study was to evaluate management methods applied to improve working conditions in Polish enterprises implementing TQM. The investigation was conducted in the form of interviews, which covered relevant connections between the TQM concept and occupational health and safety (OHS) systematic management rules. The results revealed that the criteria adopted in investigated enterprises for OHS management systems, as well as the implemented management methods and tools, can be evaluated positively. However, many require significant improvement in order to ensure better compliance with the existing law provisions. Elements of OHS management systems also require better integration with the overall management system of the enterprise.

Evaluation Studies as Topic↗

[Maintaining safety management in the field of surgery].

Due to an increase in the number of medical accidents and medical conflicts, the administration of medical safety has recently introduced the following measures to cope with this situation; the process and the structure (reason) of error is analyzed based upon evidential facts, the origin of the errors is analyzed mainly in terms of teamwork and specialized medicine and structures rather than in terms of the ability of the individual, and the strategy against medical errors has been converted from aspects of management to prevention. The comprehensive strategy pursued now covers the field of social medical systems in addition to medical institutions. However, the judicial decisions in 90% of medical conflicts ruled that these were caused by the lack of knowledge and skills of the medical doctor, and a survey performed by the Japan Medical Association based on medical insurance research has reported incidences of repeated medical errors by the same physician. This has led to some criticism from the victim's viewpoint that insufficient administration of medical quality result in increased numbers of accidents which are due to repeated medical errors, under "legal" medical practice by "incompetent" doctors who should have been systematically reeducated or dismissed. In recent years, several societies and research groups of the Ministry of Health, Labour and Welfare have constructed medical guidelines based on evidence-based medicine techniques. The introduction of the clinical pathway offers the medical team access to information, directed to the appropriate roles, which may be helpful in performing constant safety checks. This medical check method that involves the patient's input will also contribute to the prevention of medical errors and promotion of safety.

Critical Pathways↗

[Safety management in operating rooms].

In operating rooms, patients with a wide range of conditions are transferred from the wards to undergo surgery. Furthermore, because surgeons with different specialties perform various operations using instruments unique to their specialty, it is possible that operating room nurses, surgeons, and ward nurses do not always communicate clearly. Patients are anesthetized and unconscious, and as a general rule, family members are not allowed entry. As a result, operating rooms are unique environments where neither the patients receiving medical services nor their families can express opinions and concerns. Therefore an especially strict crisis management approach is needed in operating rooms. At present, individual hospital implement their own crisis management systems to prevent medical accidents. However, national debate is needed to establish medical accident prevention guidelines before each hospital compiles a manual that suits its needs.

Operating Rooms↗

[Patient safety management in surgery].

This article deals with practical guidelines for informed consent to surgery and strategies to avoid adverse events during the operative and postoperative periods. It also describes what to do in the event of accidents and what should or should not be done to avoid medical litigation.

Informed Consent↗

Laser safety management.

LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. Since the first working laser was demonstrated in 1960 the laser has evolved from being viewed as a weapon, courtesy of the film industry, to its current position as a commonplace medical device within the healthcare industry. As perioperative staff we have become very familiar with the therapeutic use of this device. It is my experience however that, just occasionally, we are guilty of the old adage 'familiarity breeds contempt'. We must remember that the very same features which make lasers so useful in healthcare may also represent major health hazards to patients, staff and others.

Eye Protective Devices↗

Effective systems documentation: essential for safety management.

The rapid pace of change in healthcare has caused critical engineering systems in hospitals and other healthcare facilities systems to be altered and upgraded on a virtually continuous basis. Changes to these systems, which include heating, ventilating, and air conditioning (HVAC), medical gases, normal and emergency electrical systems, plumbing, and fire protection systems, often are not properly documented. As a result, healthcare facilities may, over time, be exposed to increased risk. Such a situation compromises an organization's high level of patient and staff safety; it also may cause problems during a Joint Commission on Accreditation of Healthcare Organizations review of environment of care. This article outlines seven specific questions safety officers should review to determine if their facility needs a thorough systems assessment.

Documentation↗