集对分析模型在骨科手术器械质量追踪管理中的研究

Research of set pair analysis model in quality tracking management of orthopedic surgical instruments

目的:探讨集对分析(SPA)模型优化质量追踪路径在骨科手术器械质量追踪管理中的应用价值。方法:从骨科手术器械实时追踪能力、人员职责落实、交接管理规范、维护保养执行、清洗消毒水平和问题处理效率方面制定质量评估指标体系,计算管理实际与管理目标的联系度,根据质量追踪评估结果,制定骨科手术器械管理图谱和结构-过程-结果模式的管理路径。选取医院临床在用的55634件骨科手术器械包,根据管理模式不同将其分为对照组(27465件)和观察组(28169件),对照组采用常规管理,观察组采用基于SPA模型的质量追踪管理,对比两组不良事件发生率、骨科器械管理质量和医护人员对器械使用满意度评分。结果:观察组28169件器械包中骨科手术器械丢失率、异常损坏率、器械派送延误率和器械包不规范装配率分别为0.08%(23/28169)、0.06%(18/28169)、0.10%(27/28169)和0.08%(22/28169),均低于对照组,差异有统计学意义(x^(2)=6.543,x^(2)=7.095,x^(2)=5.843,x^(2)=6.118;P<0.05);观察组清洗消毒合格率、器械包装合格率和器械供应及时率分别为99.79%(28110/28169)、99.83%(28121/28169)和99.85%(28127/28169),均高于对照组,差异有统计学意义(x^(2)=4.194,x^(2)=4.384,x^(2)=4.298;P<0.05);观察组的骨科器械使用满意度评分分别为(93.11±6.25)分和(91.19±5.74)分,均高于对照组,差异有统计学意义(t=8.683,t=8.109;P<0.05)。结论:基于SPA模型的骨科手术器械质量追踪管理可有效降低器械不良事件发生率,提高配包到位率和器械包合格率,提升骨科器械管理质量和医护人员的使用满意度。

Objective:To optimize the quality tracking path by using set pair analysis(SPA)model and to explore its application value in the quality tracking management of orthopedic surgical instruments.Methods:A quality evaluation index system was established from the aspects of real-time tracking ability of orthopedic surgical instruments,implementation of personnel responsibilities,handover management norms,maintenance implementation,cleaning and disinfection level,problem handling efficiency,and the connection degree between management practice and management objectives was calculated.According to the quality tracking evaluation results,the management map of orthopedic surgical instruments and the management path of the structure-process-outcome model were formulated.A total of 55,634 orthopedic surgical instrument kits in clinical use of the hospital were selected and divided into control group(27,465 pieces)and observation group(28,169 pieces)according to different management modes.The control group adopted routine management,and the observation group adopted quality tracking management based on SPA model.The incidence of adverse events,quality of orthopedic instruments management and satisfaction of medical staff were compared between the two groups.Results:The loss rate,abnormal damage rate,delayed delivery rate and irregular assembly rate of orthopedic surgical instruments in the observation group were 0.08%(23/28,169),0.06%(18/28,169),0.10%(27/28,169)and 0.08%(22/28,169),respectively,which were lower than those in the control group,the difference was statistically significant(x^(2)=6.543,x^(2)=7.095,x^(2)=5.843,x^(2)=6.118;P<0.05).The qualified rate of cleaning and disinfection,the qualified rate of device packaging and the timely supply rate of instruments in the observation group were 99.79%(28,110/28,169),99.83%(28,121/28,169)and 99.85%(28,127/28,169),respectively,which were higher than those in the control group,the difference was statistically significant(x^(2)=4.194,x^(2)=4.384,x^(2)=4.298;P<0.05).The satisfaction score of orthopedic surgical instruments use in the observation group was(93.11±6.25)points and(91.19±5.74)points,respectively,which were higher than those in the control group,the difference was statistically significant(t=8.683,t=8.109;P<0.05).Conclusion:The quality tracking management of orthopedic surgical instruments based on SPA model can effectively reduce the incidence of adverse events,increase the delivery rate of packages and the qualified rate of instrument packages,and improve the management quality of orthopedic instruments and the clinical satisfaction of medical staff.