追踪法结合PDCA在首台手术准时性管理的实践

Application of Tracking Method combined with PDCA in Punctuality Management on Day's First Surgery

目的对我院首台手术准时性管理现状进行分析和改进,为手术流程的优化和效率提高提供参考依据。方法运用追踪法与PDCA管理工具,采用自行设计外科首台手术准时性跟踪记录表,6月份在胸外科、骨科试点推行首台手术准时性管理,分析和持续改进影响首台手术准时开始的原因,7-12月全面推开并收集所有外科择期手术首台准时性数据。结果胸外科、骨科首台手术因术前准备复杂,准时性明显低于其他科室;而主刀医生不能按时到位,患者情绪紧张致血压过高使手术不能按时开始,术前必要的检查未做等是首台手术开始延迟的主要原因。结论手术团队各自间节点的衔接对首台手术准时性管理非常重要,手术部工作流程改善、现场追踪评估和持续改进大大提高了手术室使用率与工作效率。

Objective To analyze and improve the punctuality management on first surgeryin our hospital, which could provide reference for optimizing surgical process and improving efficiency. Methods With tracking method, PDCA management tools anda self-designed first surgery punctuality track record table, pilot punctuality management on first surgerywas carried out in cardiothoracic department and orthopedics department in June Through analysis on the reasons that impacts the punctuality of first surgery and continuous improvement, punctuality management was rolled out in hospital from July to December and the punctuality data of first surgery was collected. Results Due to complex preoperative preparation, the punctuality first surgery for cardiothoracic department and orthopedics department was significantly lower than other departments. Other main reasons for the delay of first surgery included the unpunctuality of surgeon, high blood pressure caused by patient emotional stress andthe lack of necessary preoperative examinations. Conclusion Thecohesion in surgical team is very important for the punctuality management on first surgery. The improvement of workflow, in-site tracking assessment and continuous improvement could greatly improve the utilization ofoperating room and work efficiency.