临床路径的质控策略探讨

Discussion on Quality Control Strategy of Clinical Pathway

目的分析临床路径系统变异产生主要因素,探讨在不增加工作负担的前提下,能保证路径实施效果的质控策略。方法采用回顾性研究的方法,调取并分析某院2017年4月-2017年8月进入临床路径系统管理产生的变异记录明细。结果研究周期内变异率为60.21%,其中药品类、化验类、检查类产生的变异累计构成比为80.41%,为主要的变异项目;更换路径内用药、入院即合并其他疾病、更换同类检查检验项目产生的变异累计构成比为78.83%,为主要的变异原因。结论系统对变异的记录过于详细,质控工作量巨大,因此应从设置管控目标、抓住主要质控点这两方面进行管控。

Objectives To analyze the main factors of the variation of the clinical path system, and discuss the quality control strategy that could guarantee the effect of the path implementation without increasing the burden of work. Methods The retrospective study method was used to extract and analyze the variation records of the clinical path system management in a hospital from April to August in 2017. Results To study on the mutation rate period was 60.21%, the variation of medicines, testing, inspection of the cumulative percentage was 80.41%, mainly for project variation, changes the path of medication, admitted with other diseases, replacement of the same inspection project structure variation cumulative ratio was 78.83%, were the main reasons for the variation. Conclusions The system was too detailed, thorough and quality control for the ＂variation＂ record. Therefore, strategies and key breakthroughs should be changed. We should control the implementation effect from two aspects, namely, setting up control goals and grasping the main quality control points.