戴明环在日间腹腔镜下胆囊切除术临床路径关键环节的持续改进

发布时间：2018-04-22 01:06

本文选题：临床路径 + 戴明环　；参考：《重庆医学》2017年23期

【摘要】：目的探讨利用戴明环(PDCA)对日间腹腔镜下胆囊切除术(LC)临床路径进行持续质量改进的效果评价。方法选择该院日间手术中心的日间LC患者为受试对象,将2014年1-12月采用初始日间LC临床路径管理的610例患者设为对照组;2015年1-12月采用通过PDCA优化后的LC临床路径管理的716例患者设为研究组,比较两组的变异差异情况。结果通过PDCA管理,日间LC临床路径完成率从93.3%(569/610)提高到97.9%(701/716),差异有统计学意义(P0.01);临床路径变异率由11.5%(70/610)降低至2.9%(21/716),差异有统计学意义(P0.05)。结论通过PDCA不断修订和持续改进减少日间LC临床路径变异的发生,使得临床路径更加合理有效,进一步保障了日间手术的质量和安全。
[Abstract]:Objective to evaluate the effect of continuous quality improvement on the clinical pathway of day laparoscopic cholecystectomy (LC) by using PDCA. Methods the day LC patients in the day operation center of our hospital were selected as subjects. 610 patients with initial day LC clinical pathway management were set up as control group from January to December 2014, and 716 patients with LC clinical pathway management optimized by PDCA from January to December 2015 were set up as study group to compare the difference of variation between the two groups. Results through PDCA management, the completion rate of clinical pathway in daytime LC was increased from 93.3 / 569 / 610) to 97.9 / 701 / 716, the difference was statistically significant (P 0.01), and the rate of variation of clinical pathway was decreased from 11.55 / 70 / 610) to 2.9% 21 / 716 (P 0.05). Conclusion through the continuous revision and continuous improvement of PDCA to reduce the incidence of variation in the clinical pathway of daytime LC, the clinical pathway is more reasonable and effective, which further ensures the quality and safety of daytime surgery.
【作者单位】：四川大学华西医院日间服务中心;四川大学华西医院全科医学科;
【基金】：四川省医学科研青年创新课题(Q15048) 四川省科技技术厅科研课题(2017ZR0056) 四川省卫生厅科研课题(130104)
【分类号】：R197.323;R657.4

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