PDCA循环法对提高ICD编码质量的效果分析

Effect Analysis of PDCA Circulation Method on Improving ICD Coding Quality

目的分析戴明环(plan do check action,PDCA)循环法对提高国际疾病分类(international classification of diseases,ICD)编码质量的效果。方法回顾性分析本院于2018年1月-2019年12月随机抽取的病案首页950份出院病案,通过核对、检查、总结等描述性统计,在2019年开展PDCA循环法质量管理,对病案首页出院病案正确率的影响因素进行分析,同时制定目标(编码正确率需达到100.00%),讨论科学合理且有效的整改方案,最后评价管理方法实施前后的实际效果。结果在2019年开展PDCA循环法质量管理后,病案首页出院病案ICD编码正确率明显提高,且基本与目标值持平,正确率由2018年52.84%(251/475)提高到95.16%(452/475),差异有统计学意义(P<0.05)。结论在ICD编码质量管理中采用PDCA循环法效果尤为显著,能够有效提升病案首页病案编码正确率,有利于促进医疗质量持续性提高,具有较高的临床应用价值。

Objective To analyze effect of plan do check action(PDCA)circulation method on improving coding quality of international classification of diseases(ICD).Methods The paper reviewed and analyzed 950 discharged medical records from first page of medical records in our hospital from January 2018 to December 2019 randomly.Based on checking,examining,summarizing and other descriptive statistics,PDCA circulation quality management was carried out in 2019 to analyze influencing factors of accuracy of discharged medical records on first page of medical records.At the same time,the paper formulated goal(coding accuracy should reach 100.0%),discussed scientific,reasonable and effective rectification plans,finally,it evaluated actual effect before and after implementation of management method.Results After PDCA cycling quality management was carried out in 2019,correct rate of ICD code of first page of discharged medical record was significantly increased,which was basically the same as target value.Correct rate increased from 52.84%(251/475)in 2018 to 95.16%(452/475),with statistically significant difference(P<0.05).Conclusion PDCA circulation method is particularly effective in ICD coding quality management,can improve accuracy of medical record coding on first page of medical record effectively,promote continuous improvement of medical quality,which has high clinical application value.