基于数据包络分析模型的重症监护病房呼吸机安全质量管理效果评价

Evaluation of safety and quality management effect of ventilators in intensive care unit based on data envelopment analysis model

目的:探讨评价数据包络分析(DEA)模型在重症监护病房呼吸机安全质量管理中的应用效果。方法:在查尼斯-库珀-罗兹(CCR)对偶模型基础上增加约束条件构成投入导向的班克-卡内斯-库珀(BCC)模型构建DEA模型,从DEA模型的124个关联事项中确定20个高相关水平关联事项开展临床服务效率关联的呼吸机质量控制管理。选取2021年10月至2023年9月江苏省人民医院重症监护病房在用的33台呼吸机设备,其中2021年10月至2022年9月期间使用的呼吸机采用传统质量控制管理方法进行管理,2022年10月至2023年9月期间使用的呼吸机采用DEA模型进行管理。对比两种管理方法的呼吸机使用管理参与主体满意度评分、管理质量评分和临床使用效率评分。结果:医护人员、患者和设备工程师对采用DEA模型管理方法的呼吸机管理的平均满意度评分分别为(96.68±2.25)、(96.32±2.18)和(95.66±2.54)分,均高于传统质量控制管理方法,差异有统计学意义(t=10.940、15.220、6.674,P<0.05);采用DEA模型管理方法的呼吸机运行性能、检查操作安全和使用及时性平均评分分别为(4.44±0.31)、(4.53±0.37)和(4.61±0.36)分,均高于传统质量控制管理方法,差异有统计学意义(t=12.692、14.979、17.025,P<0.05);采用DEA模型管理方法的呼吸机工作效率、呼吸机响应时间效率和呼吸机治疗效率平均评分分别为(4.49±0.32)、(4.75±0.35)和(4.68±0.32)分,均高于传统质量控制管理方法,差异有统计学意义(t=21.179、16.785、16.347,P<0.05)。结论:采用DEA模型对重症监护病房呼吸机进行管理,能够提高呼吸机临床服务效率,提升呼吸机使用管理人员满意度和呼吸机管理质量。

Objective:To explore the application effect of data envelopment analysis(DEA)model in the safety and quality management of ventilators in intensive care units.Methods:Based on the Chanis-Cooper-Rhodes(CCR)dual model,by adding constraints,the input-oriented Bank-Carnes-Cooper(BCC)model was constructed to construct the DEA model.Among the 124 related items in the DEA model,20 high-level related items were identified to carry out ventilator quality control management related to clinical service efficiency.A total of 33 ventilators in clinical use in the intensive care unit(ICU)of Jiangsu Province Hospital from October 2021 to September 2023 were selected.Among them,the ventilators used from October 2021 to September 2022 were managed by traditional quality control management methods,and the ventilators used from October 2022 to September 2023 were managed by DEA model.The satisfaction scores,management quality scores and clinical efficiency scores of participants in ventilator use management were compared between the two management methods.Results:The satisfaction scores of medical staff,patients and equipment engineers for ventilator management using the DEA model management method were(96.68±2.25)points,(96.32±2.18)points and(95.66±2.54)points,respectively,which were higher than those of the traditional quality control management method,the difference was statistically significant(t=10.940,15.220,6.674,P<0.05).The average scores of ventilator operation performance,inspection operation safety and timeliness using DEA model management method were(4.44±0.31)points,(4.53±0.37)points and(4.61±0.36)points,respectively,which were higher than those of the traditional quality control management method,the difference was statistically significant(t=12.692,14.979,17.025,P<0.05).The average scores of ventilator work efficiency,ventilator response time efficiency and ventilator treatment efficiency using the DEA model management method were(4.49±0.32)points,(4.75±0.35)points and(4.68±0.32)points,respectively,which were all higher than those of the traditional quality control management method,with statistically significant differences(t=21.179,16.785,16.347,P<0.05).Conclusion:The application of the DEA model in the management of ventilators in ICU can improve the efficiency of ventilator clinical service,improve the satisfaction of ventilator management personnel and the quality of ventilator management.