某三级医院放射科实施质量控制前后效果评价分析

Analysis of the Effect Evaluation before and after the Implementation of Quality Control in the Radiology Department of a Certain Tertiary Hospital

目的:评价放射科实施质量控制管理的效果。方法:以该院放射科在2019年9月开始实施基于PACS(Picture Archiving and Communication System,医学图像归档与通讯系统)/RIS(Radiology Information System,放射信息系统)的系统质量控制管理模式为时间节点,采用随机化对照试验。(1)随机选择2018年8月-2019年7月于放射科接受DR检查(A组)和CT、MR检查(C组)的患者各4000例;随机选择2019年9月-2020年8月于放射科接受DR检查(B组)和CT、MR检查(D组)的患者各4000例,即A、C组采用常规管理模式,B、D组采用基于PACS/RIS的系统质量控制管理模式。分别对两种模式下患者的图像质量等级、报告书写合格率及诊断符合率指标进行评分和分析。(2)随机抽取2018年8月-2019年7月和2019年9月-2020年8月(即实施质量控制管理前后)甲、乙、丙、丁四位初级医师其个人报告各2000份,比较其在实施质量控制管理前后(自身对照)各自报告的优率、合格率和不合格率。结果:(1)B、D组患者的评分显著高于A、C组(P<0.01)。(2)B、D组患者的图像质量等级、报告合格率、诊断符合率均显著高于A、C组(P<0.01)。(3)四位医师在实施质量管理控制后,其个人的报告优率、报告合格率均明显提高(χ^(2)_(甲)=4.93、36.04,χ^(2)_(乙)=6.65、37.94,χ^(2)_(丙)=5.27、43.80,χ^(2)_(丁)=9.36、26.73,P<0.01)。结论:放射科实施质量控制管理不仅能够提升图像质量,且能显著提升报告合格率及诊断符合率。

Objective:To evaluate the effect of quality control management in radiology department.Methods:Taking the radiology department of the hospital to implement the system quality control management mode based on PACS(Picture Archiving and Communi⁃cation System)/RIS(Radiology Information System,Radiology Information System)in September 2019 as the time node,adopt random⁃ized controlled trial.①A total of 8000 patients who received DR examination,CT examination and MR examination in radiology depart⁃ment from July 2018 to August 2020 were randomly selected and randomized controlled experiment was conducted.The former(DR)was randomly divided into two groups:A and B,with 4000 patients in each group.The latter were randomly divided into group C and GROUP D with 4000 cases in each group.Group A and C were treated with conventional management mode,while group B and D were treated with PACS(Picture Archiving and Communication System.The image quality grade,qualified rate of report writing and di⁃agnostic coincidence rate of patients under the two modes were scored and analyzed respectively.②甲乙丙丁were randomly selected from 2000 individual reportsduring August 2018 to July 2019 and September 2019 to August 2020,before and after the implementa⁃tion of quality control management to compare the excellent rate,qualified rate and unqualified rate of their reports before and after the implementation of quality control management(self control).Results:①The score of group B and D was significantly higher than that of group A and C(P<0.01).②The image quality grade,report qualified rate and diagnosis coincidence rate of patients in group B and D were significantly higher than those in group A and C(P<0.01).(3)After the implementation of quality management control,the rate of excellent report and the rate of qualified report were significantly increased(χ^(2)_(甲)=4.93、36.04,χ^(2)_(乙)=6.65、37.94,χ^(2)_(丙)=5.27、43.80,χ^(2)_(丁)=9.36、26.73,P<0.01).Conclusion:Radiology department can not only improve image quality,but also significantly improve the rate of qualified report and diagnosis coincidence.