基于PDCA循环构建住院患者血糖主动干预运营管理模式的实践研究

Performance Surveillance of Active Blood Glucose Management during Hospitalization Based on the PDCA Cycle:a Practical Study

住院患者血糖控制的临床需求增加催生临床新技术与医疗模式转变,为医疗管理带来了挑战。本文利用PDCA(Plan-Do-Check-Action)循环构建住院患者血糖主动干预运营管理模式。从“人”“机”“料”“法”“环”5个维度抽象化实际管理问题,运用PDCA循环质量管理工具,通过“计划-执行-检查-处理”循环,推进运营管理模式构建,最终建立多部门联动机制,形成分级管理制度、流程和血糖管理信息化系统,建立质量控制体系和绩效运营保障体系。利用PDCA循环构建住院患者血糖主动干预运营管理模式在四川大学华西医院推广顺利,并取得一定成效,血糖管理后患者72 h血糖达标率逐月上升。因此,本院基于PDCA循环构建住院患者血糖主动干预运营管理模式可为其他医疗机构开展血糖管理工作提供借鉴参考,对提高住院患者血糖管理水平有重要意义。

The increased clinical demand for glycemic control in hospitalized patients has led to a new transformation of clinical technologies and medical models,which has brought challenges to medical management. We built an active blood glucose intervention operation and management model for inpatients using the Plan-Do-Check-Action(PDCA) cycle:Firstly,we concertized the practical management problems through root cause analysis,namely man-machine-material-method-environment. Then,we used PDCA cycle quality management tools to facilitate the construction of the operation and management models based on the PDCA cycle. We finally formed an efficient multidepartment cooperation mechanism and tiered management system and process for inpatients,and established an information system of glycemic management,quality control system and operational performance guarantee system. By use of the model,the blood glucose management has been successfully promoted with some achievements obtained,and the rate of blood glucose meeting the target level within 72 hours after glycemic management has increased month by month in West China Hospital,Sichuan University. This model developed by our hospital may be used as a reference for other hospitals to conduct glycemic management,and it also has great significance for improving the inpatient blood glucose management.