PDCA循环在藏区医院医疗质量检查中的应用

Application of PDCA Cycle in Examination of Medical Quality in Tibetan Area Hospitals

目的探讨PDCA循环在藏区医院医疗质量检查中的应用。方法 2014年10月在红原县人民医院医疗质量检查中引入PDCA循环理论,积极收集医疗活动中存在的质量问题,分析原因及影响因素,制定计划;认真落实计划及措施实施;调查实施结果,找出问题进行效果分析;总结检查的结果,对未解决的问题,转入下一个PDCA循环,持续追踪,直至效果满意。参照《四川省二级综合性医院评审标准》,对全院内外科病房医疗质量进行检查分析,对PDCA运用前(2014年7月-9月)和运用后(2014年10月-12月)部分医疗质量检查缺陷发生率进行比较。结果医疗护理文件书写缺陷发生率由12.4%下降到5.9%,差异有统计学意义(P<0.05);医院感染管理缺陷发生率由13.5%下降到5.3%,差异有统计学意义(P<0.05);药品安全管理缺陷发生率由11.8%下降到2.5%,差异有统计学意义(P<0.05)。结论将PDCA循环应用到藏区医院医疗质量检查中,通过发现问题,查找问题发生原因,找到解决问题的方法,持续改进,很大程度上提高了藏区医院医疗质量。

Objective To explore the application of PDCA cycle in the examination of medical quality of Tibetan area hospitals.Methods In the October 2014,PDCA cycle theory was introduced into the examination of Tibetan hospital medical quality.We collected quality problems existing in the medical activities actively,analyzed the reason and influencing factors and made corresponding plans.Then we implemented the plans and measures strictly,surveyed the results,found out and analyzed the problems,summarized the results of the examination,and turned the unsolved problems to the next PDCA circulation.Continuous follow-up was performed until the results were satisfactory.Based on Sichuan Province Secondary Comprehensive Hospital Evaluation Standard,we analyzed the medical quality of the hospital before PDCA application（July to September 2014） and after PDCA application（October to December 2014）.Results The incidence of medical nursing documents writing defects decreased from 12.4%to 5.9%.Hospital infection management defect rate declined from 13.5%to 5.3%and drug safety management defect rate declined from 11.8%to2.5%,and all the differences were statistically significant（P〈 0.05）.Conclusion PDCA cycle in the Tibetan hospital for medical quality examination has greatly improved the medical quality of Tibetan hospitals.