PDCA循环法在自动乳腺全容积成像诊断乳腺疾病中的应用

Application of Plan-Do-Check-Action(PDCA)circulation method in improving diagnostic quality of automated breast volume scanner for breast diseases

目的:探讨PDCA(Plan计划,Do执行,Check检查,Action行动)循环法在自动乳腺全容积成像(ABVS)诊断乳腺疾病中的应用。方法:收集中南大学湘雅三医院2018年1月至2019年12月期间行ABVS检查并经病理确诊或临床明确诊断的乳腺疾病患者2070例,根据PDCA循环法应用时间分为2组,PDCA循环法应用前(2018年1月至2018年12月)患者840例,PDCA循环法应用后(2019年1月至2019年12月)患者1230例。使用χ2检验分析比较PDCA循环法应用前后的诊断符合率、漏诊率、误诊率以及患者满意度的差异。结果:与PDCA循环法应用前比较,PDCA实施后ABVS诊断符合率提高(87.89%vs 82.74%),误诊率下降(11.47%vs 15.63%),漏诊率下降(14.39%vs 23.20%),患者满意度提升(92.59%vs 87.12%),差异均具有统计学意义(χ2=10.856、4.507、3.936、3.922,P=0.010、0.034、0.047、0.048)。结论:PDCA循环法能提升ABVS诊断乳腺疾病过程中的医疗质量。

Objective To explore the application of the Plan-Do-Check-Action(PDCA)circulation method in improving the diagnostic quality of automated breast volume scanner(ABVS)in breast diseases.Methods A total of 2070 patients with breast diseases who underwent ABVS examination at the Third Xiangya Hospital of Central South University from January 2018 to December 2019 were enrolled in the study.All diagnoses were confirmed by pathologically or clinically.According to the cut-off time of the PDCA circulation method application(January 2019),the patients were divided into either a control group(840 patients,from January 2018 to December 2018)or an experimental group(1230 patients,from January 2019 to December 2019).The diagnostic coincidence rate,missed diagnosis rate,misdiagnosis rate,and patient satisfaction rate were compared using the Chi-square test before and after the application of the PDCA circulation method.Results After the PDCA circulation method was implemented,the diagnostic coincidence rate of ABVS increased(82.74%vs 87.89%),the missed diagnosis rate(15.63%vs 11.47%)and misdiagnosis rate(23.20%vs 14.39%)decreased significantly,and patient satisfaction rate(87.12%vs 92.59%)significantly increased(χ2=10.856,4.507,3.936,and 3.922;P=0.010,0.034,0.047,and 0.048,respectively).Conclusion The PDCA circulation method can improve the medical quality of ABVS diagnosis process,and is worthy of clinical promotion.