质量管理工具在康复临床路径管理中的应用

Application of Quality Control Tools in Rehabilitation Clinical Pathway Management

目的探讨质量管理工具在康复临床路径管理中的应用价值。方法应用PDCA循环、鱼骨图、甘特图、5W1H分析法等工具,分析本院临床路径管理现状,寻找临床路径入组率和完成率偏低的原因,制定对策并进行持续改进。按半年分级,将2013年7月至2015年12月入院(改进前)的5组数据作为对照组,2016年1月至2018年6月入院(改进后)的5组数据作为研究组,进行比较。结果研究组和对照组的出院人数无显著性差异(t <2.260, P> 0.05),两组康复临床路径和全部临床路径入组人数、变异人数和完成人数均有非常高度显著性差异(t> 6.501, P <0.001),两组康复临床路径入组率、全部临床路径入组率、全部临床路径变异率均有非常高度显著性差异(χ~2> 10.973, P <0.001)。结论科学运用质量管理工具,可以扩大临床路径病种覆盖面,有效提高临床路径入组率,降低变异率。

Objective To explore the application value of quality control tools in rehabilitation clinical pathway management.Methods Quality control tools,such as PDCA circulation,fishbone chart,Gantt chart and 5W1H,were used to analyze the clinical path implements,to find out the reasons for the low rate of clinical pathway entry and completion,and to make continuous improvement.The data from July,2013 to June,2018 were divided into ten boxes as halfa-year.The former five boxes were as control group,and the latter five boxes were as study group.Results There was no significant difference in the number of discharged patients between the study group and the control group(t<2.260,P>0.05),but there was significant difference between the two groups in the number of patients entering the rehabilitation,variation and completion in the rehabilitation and the total clinical pathway(t>6.501,P<0.001).There were significant differences in the rate of entering total clinical pathway,and the rate of the variation and the completion of total clinical pathway(χ^2>10.973,P<0.001).Conclusion Application of quality control tools can expand the implement of clinical pathway,improve the rate of entry and completion in clinical pathway,and reduce the variation.