PDCA对成人腹股沟疝临床路径评价体系的影响
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摘要
目的探讨PDCA对成人腹股沟疝临床路径评价体系的影响。方法将某院2015年10月—2017年3月成人腹股沟疝临床路径患者按PDCA循环管理模式分为实施前、实施中及实施后三组,通过对实施前后临床路径入径率、入径完成率、变异率、平均住院日及平均住院费用等质量评价指标对比分析,总结PDCA循环管理模式对临床路径质量评价体系的影响。结果应用PDCA循环对成人腹股沟疝临床路径进行管理,能明显提高临床路径入径率及入径完成率、减少变异率,且能明显缩短患者平均住院日、降低平均住院费用、降低药物费用及降低抗生素的使用率。结论对成人腹股沟疝临床路径实施PDCA循环的持续质量改进管理,有助于进一步优化临床路径的内涵,使医疗资源得到更加合理的分配,促进临床路径在医疗机构中的稳步推进。
Objective To explore the effect of PDCA on quality evaluation system of adult inguinal hernia clinical pathway. Methods According to the PDCA cycle management, the adult inguinal patients from October 2015 to March 2017 which managed in clinical pathway were divided into threegroups, the group before implementation, the group in implementation and the group after implementation of the PDCA management. The participant rate of the clinic pathway, the completion rate of clinic pathway, the variation of the clinic pathway, average of the hospitalization and average of the hospitalization expenses before and after PDCA cycle management were compared and analyzed, and the influence of PDCA cycle management on clinical path quality evaluation system was summarized. Results The application of PDCA cycle management of adult inguinal hernia clinical pathway significantly increased the participant rate and completion rate of clinic pathway,reduced the variation rate, reduced average of the hospitalization and average of the hospitalization expenses, especial the use of antibiotic. Conclusion The implementation of PDCA cycle for management of adult inguinal hernia clinical pathway will helps to further optimize the connotation of clinical pathway, make medical resources more rational distribution, and promote the steady progress of clinical pathway in medical institutions.
Objective To explore the effect of PDCA on quality evaluation system of adult inguinal hernia clinical pathway. Methods According to the PDCA cycle management, the adult inguinal patients from October 2015 to March 2017 which managed in clinical pathway were divided into threegroups, the group before implementation, the group in implementation and the group after implementation of the PDCA management. The participant rate of the clinic pathway, the completion rate of clinic pathway, the variation of the clinic pathway, average of the hospitalization and average of the hospitalization expenses before and after PDCA cycle management were compared and analyzed, and the influence of PDCA cycle management on clinical path quality evaluation system was summarized. Results The application of PDCA cycle management of adult inguinal hernia clinical pathway significantly increased the participant rate and completion rate of clinic pathway,reduced the variation rate, reduced average of the hospitalization and average of the hospitalization expenses, especial the use of antibiotic. Conclusion The implementation of PDCA cycle for management of adult inguinal hernia clinical pathway will helps to further optimize the connotation of clinical pathway, make medical resources more rational distribution, and promote the steady progress of clinical pathway in medical institutions.
引文
[1]国家卫生计生委,国家中医局.关于印发进一步改善医疗服务行动计划的沟通:国卫医发[2015]2[A/OL].(2015-1-12)[2015-1-12]http://www.nhc.gov.cn/yzygj/s3593g/201501/5584853cfa254d1aa4e38de0700891fa.shtml.
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[5]白飞,白洁,汤慧芹,等.公立医院临床路径实施病种数影响因素分析[J].中华医院管理杂志,2017,33(1):27-29.
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[7]高爱玲,陈淑梅.临床路径在腹股沟疝围手术期护理的应用效果[J].国际护理学杂志,2014,33(9):2330-2332.
[8]尹璇,郭建兵.PDCA循环在临床路径管理中的应用[J].中国病案,2017,18(9):31-33.
[9]赵红梅,赵越,郭静竹.运用PDCA推进临床路径管理[J].中国卫生质量管理,2017,24(2):48-50.
[10]章以法,曹兆兰.应用PDCA持续改进临床路径管理质量[J].江苏卫生事业管理,2018(1):53-55.
[11]赵红梅,赵越,邓芒,等.影响临床路径完成率因素分析与对策建议[J].中国医院管理,2015,35(5):27-29.
[12]田怀谷.基于变异分析的临床路径持续改进研究[J].卫生经济研究,2015(7):43-47.
[2]于微微,陈欣妤,梁昱,等.临床路径实施面临的问题与对策分析[J].现代医院管理,2014,12(6):56-58.
[3]张莹,赵琨,齐雪然,等.临床路径试点工作推广中的问题、成因与对策研究[J].中国全科医学,2013,16(10):1160-1162.
[4]奚蓓蓓,吴昕霞,张晨,等.临床路径管理与信息系统结合策略[J].中华医院管理杂志,2014,30(3):188-190.
[5]白飞,白洁,汤慧芹,等.公立医院临床路径实施病种数影响因素分析[J].中华医院管理杂志,2017,33(1):27-29.
[6]朱鸿波,韩宗明,张学贞,等.导致腹股沟疝临床路径负性变异的影响因素分析[J].国际外科学杂志,2016,43(3):186-189.
[7]高爱玲,陈淑梅.临床路径在腹股沟疝围手术期护理的应用效果[J].国际护理学杂志,2014,33(9):2330-2332.
[8]尹璇,郭建兵.PDCA循环在临床路径管理中的应用[J].中国病案,2017,18(9):31-33.
[9]赵红梅,赵越,郭静竹.运用PDCA推进临床路径管理[J].中国卫生质量管理,2017,24(2):48-50.
[10]章以法,曹兆兰.应用PDCA持续改进临床路径管理质量[J].江苏卫生事业管理,2018(1):53-55.
[11]赵红梅,赵越,邓芒,等.影响临床路径完成率因素分析与对策建议[J].中国医院管理,2015,35(5):27-29.
[12]田怀谷.基于变异分析的临床路径持续改进研究[J].卫生经济研究,2015(7):43-47.