利用焦点管理循环提高肺癌化疗患者临床路径管理效率

Improving the Efficiency of Clinical Pathway Management inLung Cancer Chemotherapy Patients with FOCUS-PDCA CycleManagement

[目的]探讨利用焦点管理(FOCUS-PDCA)循环提高肺癌化疗患者临床路径实施效率。[方法]以武汉市肺科医院2019—2021年肺癌化疗患者572例为研究对象,其中2019年122例,2020年147例,2021年303例。比较循环管理前(2019年1月1日至2019年12月31日)和循环管理后(2020年1月1日至2021年12月31日)肺癌化疗患者临床路径的入径率和医疗资源消耗情况。[结果]经过本轮FOCUS-PDCA循环管理,肺癌化疗患者临床路径入径率由2019年的31.97%提高至2021年的60.07%,中位住院费用从2019年的12192.36元降低至2021年的9146.56元,中位住院天数由2021年的13.49 d降低至2021年的9.53 d,差异均有统计学意义(P均<0.05)。[结论]FOCUS-PDCA循环管理可以有效提高肺癌化疗患者的临床路径入径率,降低肺癌化疗患者的住院费用和住院天数,提高临床路径管理效率。

[Objective]To evaluate the application of the FOCUS-PDCA(Find Organize Clarify Understand Select-Plan Do Check Act)cycle in improving the efficiency of clinical pathway implementation in lung cancer chemotherapy patients.[Methods]A total of 572 patients with lung cancer who underwent chemotherapy in Wuhan Pulmonary Hospital from 2019 to 2021 were enrolled in the study,including 122 cases admitted during January to December 2019,147 cases admitted during January to December 2020 and 303 cases admitted during January to December 2021.The clinical pathway entry rate and medical resource consumption before(January to December 2019)and after(January 2020 to December 2021)FOCUS-PDCA cycle management were compared.[Results]After the FOCUS-PDCA cycle management,the clinical pathway entry rate of lung cancer chemotherapy patients was increased from 31.97%in 2019 to 60.07%in 2021;the hospitalization costs were reduced from average 12192.36 Yuan to 9146.56 Yuan and the average length of stay was decreased from 13.49 d to 9.53 d(all P<0.05).[Conclusion]FOCUS-PDCA cycle management can effectively improve the clinical pathway entry rate,reduce hospitalization costs and length of stay for lung cancer chemotherapy patients.