应用六西格玛方法提高血流动力学稳定患者红细胞输注有效率

Six Sigma method to improve the efficacy of red blood cell transfusion in patients with stable hemodynamics

目的探讨六西格玛质量管理方法在提高患者红细胞输注有效率中的应用价值。方法项目组运用六西格玛质量管理中的定义、测量、分析、改进、控制5个步骤,对现有流程能力及影响因素进行分析,制定出相应的改进措施及控制计划,持续改进。收集本院2019年1~11月血流动力学稳定患者临床红细胞输注病例,1~3月病例为项目改进前现状分析,4~8月病例用于及时跟踪项目改进效果,9~11月病例用于跟踪项目改进后效果。分析比较改进前、后血流动力学稳定患者红细胞输注有效率及流程能力。结果改进后全院血流动力学稳定患者红细胞输注有率从76.9%提高至90.5%(F=55.32,P<0.05)。流程能力Z值从0.4080提高到1.3308,有明显改善。结论运用六西格玛质量管理方法能有效提高血流动力学稳定患者红细胞输注有效率。

Objective To evaluate the value of Six Sigma quality management method in improving the efficacy of red blood cell transfusion.Methods The five steps of definition,measurement,analysis,improvement and control in Six Sigma quality management were used to analyze the existing process capability and influencing factors,so as to formulate corresponding optimized measures and control plans for continuous improvement.The transfusion effect of RBCs in hemodynamically stable patients in our hospital from January to November in 2019 were assessed in three phases:January to March(prior to the application of Six Sigma),April to August(tracking the application of Six Sigma),and September to November(determining the effect of Six Sigma).The efficacy and process ability of RBC transfusion in patients with stable hemodynamics before and after the improvement were analyzed and compared.Results After the improvement,the effective rate of RBC transfusion for hemodynamically stable patients in our hospital increased from 76.9%to 90.5%(P<0.05).The Z value of process capacity increased from 0.4080 to 1.3308,with a significant improvement.Conclusion Application of Six Sigma quality management method can effectively improve the effect of red blood cell transfusion in patients with stable hemodynamics.