基于故障溯源路径的消化内窥镜质量控制研究

Practice research on quality control management of digestive endoscope based on fault traceability path

目的:构建基于功能单元的故障溯源路径,提高消化内窥镜质量控制管理水平。方法:拆分消化内窥镜功能结构,采用贝叶斯网络分析设备故障与功能单元的关联性,制定追溯统计表进行追溯数据分析,组织开展多方协作维修,构建故障溯源路径的管理方法。选取医院临床在用的14套消化内窥镜设备,按照管理方法不同分为对照组(12套)和观察组(11套,包含对照组9套和新增加的2套),对照组采用传统经验管理,观察组采用故障溯源路径管理。采用自制满意度调查问卷调查内窥镜中心医生、护士和医学工程部工程师对消化内窥镜质量控制的管理效果,对比两组消化内窥镜维修数量、维修成本和质量管理满意度。结果:两组共发生内窥镜故障57次,其中观察组23次,对照组34次,观察组消化内窥镜故障占比为40.35%(23/57),高级维修占比为13.04%(3/23),两项均低于对照组,差异有统计学意义(x^(2)=4.246,x^(2)=6.131;P<0.05);观察组零配件费用以及技术支持和人员管理费用分别为(3.14±0.94)万元、(1.87±0.83)万元和(0.69±0.23)万元,均低于对照组,差异有统计学意义(t=4.767,t=5.052,t=4.183;P<0.05);医护人员和工程师对观察组设备的临床运行质量、故障处理效率、故障处理效果和管理制度科学性的满意率分别为97.37%、84.21%、92.11%和94.74%,均高于对照组,差异有统计学意义(x^(2)=8.610,x^(2)=12.925,x^(2)=11.860,x^(2)=15.789;P<0.05)。结论:基于功能单元的故障溯源路径管理方法能够改善消化内窥镜临床运行质量,降低维修频次和维修成本,提高设备临床服务水平。

Objective:To construct a fault traceability path based on functional units to improve the quality control and management level of digestive endoscopes.Methods:The functional structure of the digestive endoscope was decomposed,the correlation between equipment faults and functional units was analyzed by Bayesian network,the traceability statistical tables were developed for traceability data analysis,the multi-party collaborative maintenance was organized,and the fault traceability management method was formed.Fourteen sets of digestive endoscope equipment in clinical use in the hospital were selected and divided into control group(12 sets)and observation group(11 sets,including 9 sets in the control group and 2 sets newly added)according to different management methods.The control group adopted traditional experience management,and the observation group adopted fault traceability management.The self-made satisfaction questionnaire was used to investigate the management effect of the quality control of digestive endoscopes among doctors,nurses and engineers from the medical engineering department of the endoscopy center.The maintenance quantity,maintenance cost and quality management satisfaction of digestive endoscopes were compared between the two groups.Results:A total of 57 endoscopic failures occurred in the two groups,including 23 in the observation group and 34 in the control group.The proportion of digestive endoscope failures in the observation group was 40.35%(23/57),and the advanced maintenance accounted for 13.04%(3/23),which were lower than those in the control group,the difference was statistically significant(x^(2)=4.246,x^(2)=6.131;P<0.05).The maintenance costs of spare parts,technical support and personnel management in the observation group were CNY(31.4±9.4)thousand,CNY(18.7±8.3)thousand and CNY(6.9±2.3)thousand respectively,which were lower than those in the control group,and the difference was statistically significant(t=4.767,t=5.052,t=4.183;P<0.05).The satisfaction of medical staff and engineers with respect to the clinical operation quality,fault handling efficiency,fault handling effect and scientificity of the management system of the equipment in the observation group was 97.37%,84.21%,92.11%and 94.74%,respectively,which were higher than those in the control group,the difference was statistically significant(x^(2)=8.610,x^(2)=12.925,x^(2)=11.860,x^(2)=15.789;P<0.05).Conclusion:The fault traceability path management method based on functional unit can improve the clinical operation quality of digestive endoscope,reduce the maintenance frequency and cost,and improve the clinical service level of the equipment.