基于信息系统的妇产专科医院危急值闭环管理实践

Closed Loop Management Practice of Critical Value in Obstetrics and Gy⁃necology Hospital Based on Information System

目的探讨危急值管理信息化及管理流程改造前后临床危急值闭环管理的方法与成效。方法浙江大学医学院附属妇产科医院于2020年7月1日启用危急值信息系统,并改造管理流程,信息系统自动反馈加钉钉点对点提醒。收集危急值系统启用前(2019年7月1日—2020年6月30日)登记的3340例(已反馈的3123例,反馈率93.50%)和流程改造后(2020年7月1日—2021年6月30日)登记的2604例危急值(已反馈2604例,反馈率100%),分别计算反馈及时率及危急值病程记录及时率数据,用间断时间序列分析比较改造前后变化趋势。结果在流程改造之后危急值的反馈及时率瞬时变化比较差异有统计学意义(P<0.05),且改造后仍呈上升趋势;病程记录及时率的瞬时变化比较差异有统计学意义(P<0.05),但后续的上升趋势差异无统计学意义(P<0.05)。结论利用危急值信息系统,改造危急值管理流程,可以提高危急值上报、反馈、处理的效率,方便全流程数据记录及危急值闭环管理。

Objective To explore the method and effectiveness of the closed loop management of clinical critical value before and after the transformation of critical value management based on information system.Methods The critical value information system was launched in Women's Hospital,School of Medicine,Zhejiang University on July 1,2020,and the management process was reformed.The information system automatically feedback the point-to-point reminder of the insertion of staples.A total of 3340 cases registered before the start of critical value system(July 1,2019 to June 30,2020)were collected(3123 cases responded,the response rate was 93.50%),and 2604 critical val-ues registered after process modification(July 1,2020 to June 30,2021)(2604 cases have been feedback,the feed-back rate is 100%),the timely rate of feedback and the timely rate of critical value course record were calculated re-spectively,and the change trend before and after the reform was compared by interrupted time series analysis.Results After the process modification,the instantaneous change of the feedback time rate of the critical value the difference was statistically significant(P<0.05),and it still showed an upward trend after the modification.The instantaneous change of the timeliness rate of disease course recording the difference was statistically significant(P<0.05),but the subsequent upward trend the difference was not statistically significant(P<0.05).Conclusion Using the critical value information system to reform the critical value management process can improve the efficiency of critical value report-ing,feedback and processing,and facilitate the whole process data recording and closed loop critical value manage-ment.