浅析四川省克山病项目质量控制措施

Introduction to quality control methods for Keshan disease project in Sichuan

目的了解和掌握四川省克山病项目执行过程中质量控制出现和发现的问题,探索克山病项目质量控制措施与方法。方法审核清理四川省2009～2011年克山病项目工作原始调查体检表,表格、数据库;制定《四川省2010年克山病项目完成情况调查表》进行问卷调查。结果按"领导重视度、培训情况、表格数据缺失度、逻辑错误发生率、ECG分析错误率、克山病诊断困难程度、数据准确性、结果代表性"等进行分类统计,总结分析克山病质控的措施办法。结果部门领导对克山病项目工作比较重视(重视度100%);项目技术方案的制定基本合理,培训基本到位;项目工作使用的仪器使用前都经过检验较准并在有效期内;现场调查前的准备工作比较充分;病例搜索范围的完成率不高;完成项目工作成员的职称结构偏低;克山病诊断困难率高;心电分析的误诊率偏高,有漏诊现象;数据缺失严重、易发生逻辑错误;一致性差等问题。结论领导重视,组织协调有力;方案细致具体,培训全面到位;准确选点,准确诊断;严格项目资料的调查搜集;审核清理规范管理项目档案资料,相关部门积极参与紧密配合;承担项目工作人员技术过硬,责任心强;层层把关,步步控制应该是克山病项目质量控制行之有效的措施。

Objective To understand and manage problems encountered during the process of conducting and exploring quality control methods for the Keshan Disease Project in Sichuan. Method Audited and corrected the collected original surveying physical examination data; formulated ＂Progress Questionnaire for 2010 Sichuan Keshan Disease Project＂ and conducted surveys based on it. Quality control methods were concluded and analyzed by categorizing surveying results according to criteria such as level of concerns of senior management, training, proportion of missing data in the questionnaire tables, likelihood of logical mis- takes, likelihood of ECG analytical mistakes, difficulty level of diagnosing Keshan Disease, accuracy of surveying data and repre- sentativeness of the surveying results. Result Department head paid great attention for the Keshan Disease Project with 100% level of concern; formulation of technical proposal was reasonable and training was well conducted. Apparatus were within expire dates and were calibrated accordingly before use; preparation of site survey was sufficient. While problems exposed included： not all cases of illness were covered; majority of the project faculty had relatively low professional tides; difficulty level of diagnosing Keshan disease was high; level of wrongly diagnosing by electrocardiogram analysis was high with occasional missed diagnosis; a lot of data was missed; likelihood of logical mistakes was high and poor consistency, etc. Conclusion Effective ways towards pre- mium quality control for Keshan Disease include： support from the management, excellent organization, detailed plan, compre- hensive training program, accurate site chosen and diagnose, stringent information collecting mechanism, standardized data man- agement system, close collaboration of each involved party, strong technical capability of participated project faculty and their being highly responsible and excellent supervision mechanism for each level.