变异管理在临床路径持续改进中的作用-《中国卫生质量管理》

文章信息/Info

Title:: Analysis about Variation Management in Continuous Improvement of Clinical Pathway

Author(s):: SONG Li; FAN Lihong; Department of Medical Service,Shanghai Sixth Heople’s Hospital,Shanghai Jiaotong University,Shanghai,200233,China

Keywords:: Clinical Pathway; Variation; Classification; Continuous Improvement; Analysis

摘要:: 目的分析临床路径变异因素,并对变异因素进行分类,针对变异种类采取有效控制措施,为临床路径的持续改进提供保障。方法回顾性调查2009年各主要科室临床路径的执行率,分析路径的变异原因,并讨论应对措施。结果在导致临床路径变异的众多因素中,主要来自三方面的影响:医院方面,医护人员和病人方面。来自病人方面的原因占62%,这方面因素大多是不可控因素,是难以避免的;来自医务人员方面的占28%;来自医院方面的占10%,来自医院方面的因素又细分为多方面。

Abstract:: Objective The paper analyzed the variation factor in clinical pathway,classified variation factor,took effective actions in accordance with variation types,provided basical ensure for continuous improvement of clinical pathway.Method The paper investigated retrospectively the implementation efficiency of clinical pathway in clinical departments in 2009;analyzed variation factors,and discussed countermeasures.Result There were three main variation factors which were from hospital,medical staff and patients,accounting for 62%,28% and 10% respectively.Variation factor from patients could not be controlled;and variation factor from hospital could be classified to many respects,such as the poorer communication between departments,out-dated hospital equipments,etc