基于数据的软式内镜故障循证管理实践

The practice of evidence-based flexible endoscope faults management based on data

目的以信息化手段采集数据作为依据,以循证管理的方法对软式内镜进行故障管理,降低严重故障的发生率,控制维修成本。方法 2017年1月-2018年12月通过对中日友好医院消化科2015年-2018年软式内镜使用、测漏、洗消、维修等数据的采集和分析,得出软式内镜故障的三大原因:测漏不及时、操作不规范、物理化学损耗,针对这些原因制定相应的管理方案:测漏监管、故障追溯和可靠性维修,并在实施中持续改进,最后统计各等级故障发生率和维修费用的变化。结果经过2年的管理实践,与2015年-2016年相比,2017年-2018年软式内镜的A、C级故障年均发生率分别下降10.3个百分点和16.7个百分点,年均维修费下降53.2%。结论应用循证管理的理念,以数据作为基础,从软式内镜故障的根源入手制定并实施一系列针对性的管理方案,可有效控制软式内镜的维修成本,基于数据的循证管理理念在医疗设备故障管理中有着广阔的应用前景。

Objective Using the evidence-based management to manage the flexible endoscope based on the data collected by information means, to reduce the rate of serious faults and control maintenance costs. Methods From January 2017 to December 2018, we collected and analyzed the flexible endoscope data of the use, leak detection, washing and disinfection, and maintenance between 2015 and 2018 from the Gastroenterology Department of our hospital. Three main causes of flexible endoscope faults were found: delayed leak detection, irregular operation, and physical/chemical wastage. Management schemes(i.e., leak detection supervision, fault tracing, and reliability maintenance) were enacted according to these reasons. These schemes were improved continuously in the implementation. Finally, we calculated the changes of the fault rate of each grade and the maintenance cost. Results By two years management practice, compared with those from 2015 to 2016, the annual rates of grade A and grade C faults of flexible endoscope from 2017 to 2018 decreased by 10.3% and 16.7% respectively, and the annual average maintenance cost fell by 53.2%. Conclusions The maintenance costs of flexible endoscope could be effectively controlled by enacting and implementing a series of targeted management schemes based on the data from the root causes of faults applying the evidence-based management.Evidence-based management based on data has a broad application prospect in the management of medical equipment faults.