三级联动专项质量管理模式的构建与应用

Construction and application of the three-level collaborative quality management system

目的：构建三级联动专项质量管理模式，并评价其在临床护理质量管理中的应用效果。方法：将护理临床质量控制检查、不良事件管理、患者满意度调查结果进行综合分析，筛选重点问题组成专项质量管理项目，护理部、科护士长、护士长混编组成联动组织，每2～3周按照“入科调研--分析评估--查找问题--计划改进--效果评价”的模式进行一轮专项质量管理，直至所有入选的问题项目均得到整改落实。结果：实施12轮三级联动专项质量管理，共有2403条问题被整改、落实，有13项护理相关制度、3项护理流程、1项管理规范被修订并标准化。实施后5项Ⅰ级护理质量评价得分、患者满意度调查得分均高于实施前，差异均有统计学意义（P〈0.05）。结论：实施三级联动专项质量管理，加强了对重点问题、薄弱环节的质量管理，促进了护理质量持续改进与稳步提高。

Objective：To set up the speciifc three-level collaborative quality management system and evaluate its effects. Methods： The results of clinical nursing quality control inspection, management of adverse events and patient satisfaction survey were comprehensively analyzed and the key problems were selected as the specific projects of quality management. The three-level collaborative quality control group which included members form nursing department, supervisors, and head nurses implemented PDCA cycle to manage the problems every 2~3 weeks until all of them improved. Results：After 12 rounds of three-level collaborative quality management activities, the authors corrected 2403 problems, revised 13 items of nursing related regulation system, three nursing processes and one management standard. Five items of level-1 care quality scores and patient satisfaction were higher than before （P＆lt;0.05）. Conclusion： The implementation of the three-level collaborative quality management system could enhance the management of key problems and the weak links, and thus promote the continuous improvement of nursing care quality.