基于FOCUS-PDCA管理法的腔镜器械质量管理实践

FOCUS-PDCA Management Method Based Quality Management of Laparoscopic Instruments

目的探讨FOCUS-PDCA管理法在腔镜器械使用周期中的应用,以期实现减少腔镜器械故障率及器械维修更新的成本支出。方法应用FOCUS-PDCA管理法对医院腔镜器械使用周期中的使用、消毒等各环节进行梳理,对故障类型进行分类并找出每个环节中导致腔镜器械故障的原因,从而制定并实施相应的改进措施。为更好地落实FOCUS-PDCA管理法,成立院内持续质量改进小组,全力推进改进措施的实施并对其效果进行评价。结果将FOCUS-PDCA管理法实施前后的数据进行对比,在腔镜手术量增长4.13%的情况下,腔镜器械故障率从6.18%下降到了3.22%,经χ~2检验得到P<0.01,改进效果具有统计学意义(χ2=8.403,P=0.0037<0.01),支出成本降低15.7万。结论应用FOCUS-PDCA程序可以对腔镜器械使用、消毒等环节进行有效的管理,可以有效降低腔镜器械故障率及支出成本,为同类研究提供了一定的参考价值。

Objective To explore the application of FOCUS-PDCA procedure in reducing the failure rate and costs of endoscopic instruments in the use period. Methods The FOCUS-PDCA procedure was employed for sorting out steps such as the use and sterilization of laparoscopic instruments in our hospital. The causes of damage to the laparoscopic instruments in each step were found out, and corresponding improvement measures were formulated. In addition, the continuous quality improvement team was established to promote the implementation of the improvement measures and evaluate the associated effects. Results Comparison of data before and after the implementation of the FOCUS-PDCA procedure suggested that the number of endoscopic surgery had increased by 4.13%, the failure rate of endoscopic instruments had decreased from 6.18% to 3.22%, the differences were statistically significant(χ^2=8403, P=0.0037<0.01). Conclusion The application of the FOCUS-PDCA procedure allows for effective management of steps such as the use and sterilization of endoscopic instruments, thus lowering the failure rate and costs of endoscopic instruments, which can supply certain reference value for similar studies.