品管圈在改善消化内镜中心管理质量中的应用

Application of quality control circle in improving management quality of Digestive Endoscopy Center

目的探讨应用品管圈(QCC)活动降低内镜故障率的应用效果来改善消化内镜中心的管理质量。方法选择2018年至2019年南京医科大学附属南京医院消化内镜中心34根日本宾得内镜的维修、维护记录和报价单。统计内镜故障溯源及产生的维修费用作为对策实施前的数据,经过QCC活动后统计2020年至2021年34根日本宾得内镜使用过程中产生的故障溯源及维修费用为对策实施后的数据。分析2018年至2019年内镜中心内镜维修记录,记录下维修频次及维修费用,借助于头脑风暴、鱼骨图及甘特图等方法进行分析,找出内镜故障的真因并针对真因制定实施对策。比较对策实施前后的维修频次及费用以评价其可行性及有效性。结果对策实施后每根内镜每季度的维修费用由对策实施前的3967.00元降为1388.00元,改善幅度为65.01%;相比较于QCC活动设定的目标值1529.00元,目标达标率为100.05%。对策实施后的内镜故障频次低于实施前(25次vs 76次),差异有统计学意义(P<0.05)。结论QCC管理能够有效降低内镜的维修成本,改善消化内镜中心的质量管理。

Objective To improve management quality of Digestive Endoscopy Center for reducing the failure rate of endoscopy by quality control circle(QCC).Methods The repair maintenance records and quotations of 34 Pentax endoscopes in Digestive Endoscopy Center of Nanjing Medical University Affiliated Nanjing Hospital from 2018 to 2019 were selected.The causes of endoscope failures and maintenance costs were counted as QCC pre-implementation data.After QCC activities,the fault tracing and maintenance costs of the 34 Pentax endoscopes from 2020 to 2021 were counted as QCC post-implementation data.The endoscope maintenance records from 2018 to 2019 were analyzed,and the maintenance frequency and costs were recorded.Brainstorming,fishbone diagrams and Gantt chart were used to identify the root cause of endoscope failure and develop countermeasures.The maintenance frequency and cost before and after countermeasures were compared to evaluate their feasibility and effectiveness.Results After implementation of countermeasures,the quarterly maintenance costs of each endoscope was reduced from 3967.00 Yuan to 1388.00 Yuan,the improvement was 65.01%.Compared with target cost of QCC activity(1529.00 Yuan),the target compliance rate was 100.05%.The frequency of endoscopic failure after imple mentation of countermeasures was lower than that of before implementation(25 vs 76),and the difference was statistically significant(P<0.05).Conclusion It is demonstrated that QCC management can effectively reduce the maintenance costs of endoscopy and improve quality management of Digestive Endoscopy Center.