[1]朱绮霞,梁 鹏,李红霞.精细化管理在提升手术室运行效率和质量中的实践及效果评价[J].医学信息,2022,35(14):102-106.[doi:10.3969/j.issn.1006-1959.2022.14.024]
　ZHU Qi-xia,LIANG Peng,LI Hong-xia.Practice and Effect Assessment of Fine Management in Improving the Operating Efficiency and Quality of the Operating Room[J].Medical Information,2022,35(14):102-106.[doi:10.3969/j.issn.1006-1959.2022.14.024]
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精细化管理在提升手术室运行效率和质量中的实践及效果评价()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年14期
页码:
102-106
栏目:
论著
出版日期:
2022-07-15

文章信息/Info

Title:
Practice and Effect Assessment of Fine Management in Improving the Operating Efficiency and Quality of the Operating Room
文章编号:
1006-1959（2022）14-0102-05
作者:
朱绮霞; 梁 鹏; 李红霞
（西安交通大学第一附属医院医务部，陕西 西安 710061）
Author(s):
ZHU Qi-xia;  LIANG Peng;  LI Hong-xia
(Medical Department of the First Affiliated Hospital of Medical College of Xi’an Jiaotong University,Xi’an 710061,Shaanxi,China)
关键词:
择期手术; 首台手术; 运行效率; 精细化管理; 医疗质量
Keywords:
Elective operations; First surgery; The operation efficiency; Refined management; Medical quality
分类号:
R197.32
DOI:
10.3969/j.issn.1006-1959.2022.14.024
文献标志码:
A
摘要:
目的 探讨精细化管理在提升手术室运行效率和质量中的应用效果。方法 从手术麻醉系统中调取2019年10月-2020年1月择期首台手术开台相关数据，将2019年10月-11月精细化管理实施前的777例手术与2019年12月-2020年1月精细化管理实施后的825例手术进行比较，分析精细化管理前后首台手术准时开台率、不同关键环节的控制情况、重点医疗质量指标变化情况。结果 实施后首台手术准时开台率高于实施前，差异有统计学意义（P＜0.05）；实施后首台手术准时开台率为68.54%~86.21%，且第5周首台手术准时开台率高于第1周，差异有统计学意义（P＜0.05）；各科室准时开台率升高绝对值为21.70%~62.40%，除老年外科和“其他科室”外，其余12个外科科室实施前后比较，差异有统计学意义（P＜0.05）；实施后未按时进入手术间、未按时完成麻醉、仅未按时开台情况低于实施前，差异有统计学意义（P＜0.05）；实施后手术间平均利用倍数、手术质量安全管理专项（手术安全核查、手术风险评估、术前医疗文书）合格率高于实施前，负性质量指标（非计划手术再返率、医疗不良事件发生率）均低于实施前，差异有统计学意义（P＜0.05）。结论 实施精细化管理能够提高准时开台率，加强对手术关键环节的控制力度，对于提升手术室运行效率和提高医院医疗质量具有重要意义。
Abstract:
Objective To discuss the application effect of refined management in improving the operating efficiency and quality of operating room.Methods From the surgical anesthesia system, the data related to the starting of the first scheduled operation from October 2019 to January 2020 were collected. Compare the 777 surgeries before the implementation of refined management from October to November 2019 with the 825 surgeries after the implementation from December 2019 to January 2020 to analyze the punctual opening rate, and the control of different key links, and the changes in key medical quality indicators before and after the refined management.Results The punctual opening rate of the first operation after implementation was higher than that before implementation, and the difference was statistically significant (P<0.05). The punctual opening rate of the first operation was 68.54%-86.21%, and the punctual opening rate of the first operation in the fifth week was higher than that in the first week (P<0.05). The absolute increase in the on-time opening rate of each department was 21.70%-62.40%, and there was statistically significant difference in 12 surgical departments between the two groups before and after implementation(P<0.05), except for Department of Geriatric Surgery and “other departments”. The situation of not entering the operation room on time, not completing anesthesia on time and only not opening the platform on time after implementation was lower than that before implementation, and the difference was statistically significant (P<0.05). After the implementation, the average utilization ratio between the operations and the qualified rate of the special items for quality and safety management (surgical safety verification, surgical risk assessment, and preoperative medical documents) were higher than those before the implementation, and the negative quality indexes (unplanned surgical return rate, and incidence of medical adverse events) were lower than those before the implementation, and the difference was statistically significant (P<0.05).Conclusion The implementation of refined management can significantly increase the punctual opening rate and strengthen the control of key procedures in the operation, which is of great significance for improving the operating efficiency of the operating room and improving the quality of the hospital.

参考文献/References:

[1]蔡滨,周罗晶,王静成,等.新医改形势下公立医院高质量发展策略思考[J].江苏卫生事业管理,2021,32(8):989-992,1008.[2]王瑞,郑超,王刚,等.影响术前平均住院日的因素分析与管理对策[J].解放军医学院学报,2021,42(6):682-685.[3]翟博雅,肖元新,牛庆东,等.流程再造提高首台手术三方准点到位率[J].中国卫生质量管理,2019,26(6):49-51.[4]温连生.区县级医院后勤精细化管理研究[D].杭州:浙江中医药大学,2020.[5]周莹,潘爱军,罗伟梅,等.提高精细化管理水平视角下医院后勤成本控制探究[J].中国市场,2021(5):112-113.[6]谢丽娜·伊力,何萍.医院精细化医疗质量控制与管理实践[J].中国卫生信息管理杂志,2021,18(4):505-508.[7]夏慧,吕雪峰,熊俊芬.医用耗材精细化闭环管理系统的应用与探索[J].中国卫生信息管理杂志,2020,17(4):489-492.[8]韩晓涛,赵颖,肖志宇,等.多维度精细化管理提高床位运营效果的实践[J].中国医院,2020,24(4):66-68.[9]林秀敏,黄雪莲,吴碧瑜.精细化管理在提高首台手术开台准点率中的应用效果[J].解放军护理杂志,2019,36(5):81-83.[10]秦君璞,刘畅,周邮,等.综合运用管理手段提升手术开接台效率的实践[J].中华医院管理杂志,2018,34(10):813-815.[11]孙璐,姚希,袁建峰,等.精细化管理在提高首台手术准时开台率中的应用[J].中国医院管理,2016,36(6):30-31.[12]周平,何静,徐少银,等.某三甲医院择期首台手术开台现状分析[J].中国临床研究,2018,31(6):843-845.[13]王春燕,金燕,吴燕燕.手术室运营效率的影响因素与改进措施[J].护理实践与研究,2018,15(24):11-13.[14]王思宇.信息化管理对哈尔滨市某医院手术室运行效率及工作质量的影响[J].医学与社会,2019,32(1):72-74.[15]张叶贤,宋金妹.精益管理在提高手术室准时开台率中的应用[J].中医药管理杂志,2019,27(11):48-49.[16]王韶莉,刘燕,曾誉.精益管理在提升手术室效率中的应用效果分析[J].黑龙江中医药,2020,49(2):138-139.[17]王丹,李新超,张欢,等.北京市三级医院手术安全核查管理现况调查[J].中国医院管理,2017,37(7):43-44.[18]朱斌.实施《手术安全核查制度》的常见误区与对策[J].麻醉安全与质控,2017,1(4):199-201.[19]张延丽,赵建军,周琳,等.某院病历书写质量管理现状[J].解放军医院管理杂志,2017,24(9):818-820.[20]孙宝全,安爱红,严庆贤.手术安全核对与手术风险评估的临床应用[J].中国医院管理,2010,30(3):28-29.

更新日期/Last Update: 1900-01-01