基于德尔菲法的临床路径动态化考核管理研究

Delphi Method Based Dynamic Assessment and Management of Clinical Pathway

目的构建临床路径动态化考核方案。方法采用专题小组讨论法、Delphi法进行三轮评分，经过遴选考核指标、确定指标权重、制定考核细则并组织实施等步骤，构建三阶段动态化考核方案。 结果调查表有效回收率均为100％，专家权威系数（Cr）分别为0.829、0.865和0.799；前两轮专家协调性系数分别为0.579和0.432，第三轮指标权重专家协调系数分别为0.900、0.650和0.776，卡方检验，结果均显示差异有统计学意义（P＜0.001）。 结论临床路径动态化考核方案有一定科学性、可靠性与合理性，具备在各级医院可复制、可推广并快速开展的特点。

ObjectiveTo establish a dynamic clinical pathway assessment scheme.MethodsBy using panel discussion and Delphi method for three rounds of marking, the three stages clinical pathway dynamic assessment scheme was constructed after steps of selecting evaluation indicators, confirming the index weight, making performance evaluation rules and implementation. ResultsThe questionnaires effective response rate was 100%, the expert authority coefficients （Cr） were 0.829、0.865 and 0.799. The initial two rounds of expert coordination coefficients were 0.579 and 0.432, respectively. The third round of index weight expert coordination coefficients were 0.900、0.650 and 0.776; and the difference was statistically significant by Chi-square test （P〈0.001）.ConclusionThe clinical pathway dynamic assessment scheme has certain scientificity, reliability and rationality, which has the characteristics of replicability, suitable for promotion and rapid development for hospitals at all levels.