根本原因分析法在缩短住院患者影像检查预约时间中的应用

Application of root cause analysis in shortening the imaging examination time of hospitalized patients

目的探讨根本原因分析法(RCA)在缩短住院患者影像检查预约时间中的应用及效果。方法选择首都医科大学宣武医院信息系统中2013年1~8月患者某四项(A^D)影像学检查的预约时间数据,按改进计划实施时间将数据分为两组,分别进行统计分析,其中1~4月为计划实施前数据,5~8月为计划实施后数据。采用RCA法查找1~4月预约时间较长的根本原因,制订针对性改进计划,并对计划实施前后的效果进行比较。结果预约时间较长的根本原因为预约患者数量显著增加、预约流程沟通不畅和检查难度增大;改进计划实施后,各监测指标均有所提高,24 h预约完成率A项检查提高最多达15.29个百分点(P=0.000),D项检查提高最低为7.74个百分点(P=0.000);C项检查与D项检查48 h完成率分别为99.85%和99.80%,接近100%。结论 RCA法为缩短影像检查预约时间提供了科学有效的解决途径。

Objective To explore the application and effects of root cause analysis （RCA） methods in shortening the appointment waiting time of image examination of inpatients. Methods Data of time of appointment waiting for four image examinations （AND） from January to August 2013 in Xuanwu Hospital Capital Medical University were statistically analyzed, the data was seperated into two parts according to duration of improving performance, The data before improving performance from data of January to April, and after data from May to August were analyzed respectively, the root causes of longer appointment waiting time from January to April were found out using the RCA methods, the targeted improvement plan were made and effects before and after the application were compared. Results The root causes of longer appointment waiting time are that a significant increasing of patients, a stumble appointment process and the increasing difficulty of image examination. After the performance of improving schedule, data under supervision got better. Appointment finishing rate A improved nearly 15.29% （P = 0.000） while rate D improved more than 7.74% （P = 0.000） in 24 h. Appointment finishing rate C was increased to 99.85% while rate D to 99.80% （P = 0.000） in 48 h near to 100%. Conclusion RCA method provided a scientific and effective way to shorten the appointment waiting time of image examination.