[1]王彦哲 赵静 杨春晓 刘文彩 位新红 郝恩刚 闫春林.急性心肌梗死合并心源性休克患者ECMO支持下急诊PCI术流程再造[J].中国卫生质量管理,2024,31(10):018-23.[doi:10.13912/j.cnki.chqm.2024.31.10.05]
　WANG Yanzhe,ZHAO Jing,YANG Chunxiao.Process Reengineering of Emergency PCI Supported by ECMO in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock[J].Chinese Health Quality Management,2024,31(10):018-23.[doi:10.13912/j.cnki.chqm.2024.31.10.05]
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急性心肌梗死合并心源性休克患者ECMO支持下急诊PCI术流程再造()
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第31卷
期数:
2024年10期
页码:
018-23
栏目:
特别关注
出版日期:
2024-10-15

文章信息/Info

Title:
Process Reengineering of Emergency PCI Supported by ECMO in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock
作者:
王彦哲 赵静 杨春晓 刘文彩 位新红 郝恩刚 闫春林
聊城市第二人民医院
Author(s):
WANG Yanzhe; ZHAO Jing; YANG Chunxiao
The Second People’s Hospital of Liaocheng City
关键词:
急性心肌梗死; 心源性休克; 体外膜肺氧合（ECMO）; 经皮冠状动脉介入术（PCI）; 首次医疗接触-梗死相关动脉开通时间（FMC-To-B）; 流程再造; 医疗质量
Keywords:
Acute Myocardial Infarction;  Cardiogenic Shock;  Extracorporeal Membrane Oxygenation（ECMO）;  Percutaneous Coronary Intervention（PCI）;  First Medical Contact to Balloon(FMC-To-B);  Process Reengineering;  Medical Quality
分类号:
R197.323
DOI:
10.13912/j.cnki.chqm.2024.31.10.05
文献标志码:
B
摘要:
目的基于哈默-流程再造理论优化急性心肌梗死合并心源性休克患者体外膜肺氧合（ECMO）支持下经皮冠状动脉介入术（PCI）救治流程，缩短首次医疗接触-梗死相关动脉开通时间（FMC-To-B）。方法设立流程再造管理团队，梳理原有流程，分析各环节非增值时间占比，制订流程优化方案，包括开发移动PDA，对堆积于急诊科的操作进行前移或后移，构建多学科协作机制，加强救治小组培训，建立多部门协同监管机制。结果流程再造后，FMC-首份心电图时间、FMC-多学科远程会诊时间、FMC-PCI知情同意时间、FMC-ECMO知情同意时间、FMC-To-B时间均较流程再造前缩短。结论再造后的救治流程可有效缩短患者FMC-To-B时间，提高医疗质量。
Abstract:
ObjectiveTo optimize the treatment process of PCI supported by extracorporeal membrane oxygenation (ECMO) in patients with acute myocardial infarction complicated by cardiogenic shock based on the Hammer-process reengineering model, and to shorten the first medical contact to balloon (FMC-To-B).MethodsThrough the establishment of a process reengineering management team, combing the original process, analyzing the proportion of non-value-added time in each link of the process, formulating process improvement plans, including the development of mobile PDA, moving forward or moving backward the operations accumulated in the emergency department, establishing a multi-disciplinary collaboration mechanism, strengthening the training of treatment teams, and establishing a multi-sectoral collaborative supervision mechanism.ResultsAfter the process reengineering, FMC-first ECG time, FMC-multi-disciplinary remote consultation time, FMC-intervention opening time, FMC-ECMO placement completion time, FMC-To-B time were shorter than before the process reengineering.Conclusion The reengineered treatment process can effectively shorten the FMC-To-B time,improve the medical quality.

参考文献/References:

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更新日期/Last Update: 2024-10-15