实施医师手术权限管理效果评价与分析

Effect Appraisal and Analysis of Surgical Doctors Permission Management

目的评价实施手术医师权限管理对手术质量和医疗安全的影响,为手术医师能力评价提供依据。方法收集新疆某三甲医院实施手术医师权限管理前后同期所有住院由本院医师主刀进行三级及以上非介入手术病例,分析手术级别、主刀医师职称、学历、专业年限与手术并发症发生率的关系。结果实施手术医师权限管理后,三级及以上手术患者例数同期增长32.66%,手术并发症发生率下降了1.74%,研究生学历组及高年资医师组的手术并发症发生率明显低于对照组。结论通过开展手术医师权限管理,有效降低了手术并发症发生率,保障了医疗安全。手术难度、手术医师学历、年资是影响手术并发症发生率的关键因素,单一采用职称与手术操作相对应的技术准入标准存在不合理性。

Objective To evaluate the impact on the quality of surgical and medical safety by implementing surgical doctors＇ permission management, to provide the basis for operation capability evaluation of surgical doctors. Methods Collecting the operation cases of the Grade 3 non-intervention and above before and after operation authority permissions management all over the hospital, and analyzing the relationship among operative grade, surgical doctors professional titles, qualifications, professional life and the incidence of surgical complications. Results After the implementation of surgical doctors＇ permission management, cases of patients undergoing the Grade 3 and above are increased by 32.66%, surgical complication rate has dropped 1.74%, and postgraduate academic groups and senior groups of surgical complication rates are significantly lower than the control group. Conclusion Through surgical doctors＇ permission management, the incidence of surgical complications is effectively reduced. Surgical difficulty, physician qualifications, seniority are the key factors of affecting the incidence of surgical complications. A single the technology access standard corresponding to the title operative is not rationa.