基于PDCA提高头颈部肿瘤TNM分期评估率的研究

Study on Improving TNM Staging Evaluation Rate of Head and Neck Tumor Based on PDCA

目的探讨应用PDCA提高头颈部肿瘤治疗前临床TNM分期评估率。方法建立改进目标工作小组,了解头颈部肿瘤治疗前临床TNM分期评估率现状,分析影响因素,制定并执行改进措施,检查改进措施执行效果。比较改进措施实施前后在医院住院治疗的头颈部恶性肿瘤患者临床TNM分期评估率。结果对照组1720份病历的TNM分期评估率为40.87%,观察组1422份病历的TNM分期评估率为93.67%,两组TNM分期评估率的差异具有统计学意义(p<0.01);不同头颈部恶性肿瘤改进措施实施前后TNM分期评估率的差异均具有统计学意义(p<0.01)。结论运用PDCA,加强临床培训,结合信息技术,进行监测、督查与反馈,可以显著提高头颈部肿瘤治疗前临床TNM分期评估率。

Objective To explore the application of PDCA in improving the evaluation rate of clinical TNM staging of head and neck tumor before treatment.Methods A working group was established to understand the current status of clinical TNM staging evaluation rate before treatment of head and neck tumor,analyze the influencing factors,formulate and implement improvement measures,and check their implementation effect.The evaluation rate of clinical TNM staging of patients with head and neck malignant tumors before and after the implementation of the improvement measures was compared.Results The TNM staging evaluation rate of 1720 medical records in the control group was 40.87%,and that of 1422 medical records in the observation group was 93.67%.The difference between the two groups was statistically significant(p<0.01).The differences of TNM staging evaluation rates before and after the implementation of different improvement measures for head and neck malignant tumors were statistically significant(p<0.01).Conclusion The application of PDCA,strengthening clinical training and implementing monitoring,supervision and feedback combined with information technology can significantly improve the evaluation rate of clinical TNM staging before treatment of head and neck tumor.