PDCA循环在基层医院脑卒中高危人群颈动脉超声筛查中的应用

Application of PDCA cycle in carotid ultrasound screening of high-risk stroke population in primary hospitals

目的探讨PDCA循环在提高基层医院脑卒中高危人群颈动脉超声筛查质量中的应用效果。方法参照PDCA循环,随机抽取超声医学影像信息系统内2020年7月至2021年4月颈动脉超声图文报告(包含图像和文字描述)50份,按质量评分标准进行评分。以甲类图文报告数占比达95%以上为目标,对报告中图像质量及文字描述存在的问题提出解决方案,于2021年5~6月拟定对策并实施改进。抽取2021年7月至2022年4月实施各项改进措施后的50份颈动脉超声图文报告进行评分,比较实施标准化医疗质量管理PDCA流程前后的超声图文报告评分、临床满意度评分变化,通过培训学习、科内讨论、收集临床反馈的问题对颈动脉超声检查流程不断优化。结果实施标准化医疗质量管理PDCA流程前,颈动脉超声图文报告评分为(87.46±5.87)分,临床满意度评分为(84.46±6.48)分,甲类图文报告数占比为58%;实施PDCA流程后,超声图文报告评分提高至(92.74±3.57)分,临床满意度评分提高至(93.06±3.96)分,甲类图文报告数占比为78%,差异均有统计学意义(均P<0.05)。结论PDCA循环有效地提高了颈动脉超声图文报告评分和临床满意度评分,可将其应用于超声科其他单病种质量控制中,以利于超声科医疗质量的不断提升。

Objective To explore the application effect of PDCA cycle in improving the quality of carotid ultrasound screening of high-risk stroke population in primary hospitals.Methods Referring to the PDCA cycle,50 carotid ultrasound graphic reports(containing images and text descriptions)from July 2020 to April 2021 in the ultrasound medical imaging information system were randomly selected,and scored according to the quality scoring criteria.With the current goal of reaching more than 95%of the number of Class A graphic reports,we proposed the solutions to the problems of image quality and text description in the reports and formulate countermeasures in May~June 2021.50 carotid ultrasound reports from July 2021 to April 2022 after the implementation of the improvement measures were selected,and the changes in ultrasound report scores and clinical satisfaction scores before and after the implementation of the standardized medical quality management PDCA process were analyzed,and continuously optimized the carotid ultrasound process through training and learning,intro-departmental discussions,and collection of clinical feedback.Results Before the implementation of the standardized medical quality management PDCA process,the carotid ultrasound graphic report score was 87.46±5.87,the clinical satisfaction score was 84.46±6.48,and the number of Class-A graphic reports accounted for 58%.After the implementation of PDCA process,the ultrasound graphic report score increased to 92.74±3.57,and the clinical satisfaction score increased to 93.06±3.96,the number of Class-A graphic reports accounted for 78%of the total number of report,the differences were statistically significant(all P<0.05).Conclusion PDCA cycle has effectively improved carotid ultrasound graphic report scores and clinical satisfaction scores,which can be applied to other single-patient quality control in the ultrasound department for the continuous improvement of ultrasound medical quality.