FOCUS-PDCA在病案归档率中的应用

Application of FOCUS-PDCA in the Filing Rate of Medical Records

目的运用FOCUS-PDCA查找病案归档率不达标的原因,并对相应的流程进行改进和完善,为等级医院评审和三级公立医院考核打好基础。方法收集某三级医院2021年1月1日-2021年6月30日的病案3日归档率和7日归档率作为实施前的数据,通过FOCUS-PDCA改进后,收集2021年8月1日-2022年1月31日的病案3日归档率和7日归档率作为实施后的数据,比较分析FOCUS-PDCA实施前后的病案3日归档率和7日归档率变化情况。结果FOCUS-PDCA应用后医院出院病案3日归档率和7日归档率分别由之前的61.10%和89.18%提升为85.97%和96.88%;FOCUS-PDCA对内科类科室的3日归档率提升效果更好,3日归档率提升超过25%,而对外科类科室和重症医学科,FOCUS-PDCA对7日归档率的提升效果更好,达到12%。FOCUS-PDCA对3日归档率(χ^(2)=1507.76,P=0.001)和7日归档率(χ^(2)=442.18,P=0.001)的提升效果明显。结论FOCUS-PDCA能有效提高医院的病案归档率,提升医院的服务质量和服务效率。

Objectives To use FOCUS-PDCA to find out the reasons why the filing rate of medical records does not meet the standard,and to improve and perfect the coresponding process,so as to lay a solid foundation for the evaluation of grade-level hospitals and the assessment of three-level public hospitals.Methods The 3-day filing rate and 7-day filing rate of medical records of a tertiary hospital from January 1st,2021 to June 30th,2021 were collected as data before implementation.After improvement through FOCUS-PDCA,and the data were collected from August 1st,2021 to January 31st,2022.The 3-day filing rate and 7-day filing rate of medical records were taken as the data after the implementation.The changes of the 3-day filing rate and 7-day filing rate of medical records before and after the implementation of FOCUS-PDCA were compared and analyzed.Results After the application of FOCUS-PDCA,the 3-day filing rate and 7-day filing rate of hospital discharge medical records increased from 61.10%and 89.18%to 85.97%and 96.88%,respectively;the 3-day filing rate had increased by more than 25%,and for surgical departments and critical care medicine departments,FOCUS-PDCA had a better effect on the 7-day filing rate,reaching 12%,FOCUS-PDCA significantly improved the 3-day filing rate(χ^(2)=1507.76,P=0.001)and the 7-day filing rate(χ^(2)=442.18,P=0.001).Conclusions FOCUS-PDCA could effectively improve the hospital's medical record filing rate,and improve the hospital's service quality and service efficiency.