[1]黄小钦任怡宋海庆陈飞王玉平.北京市脑卒中诊疗质控问题分析与改进[J].中国卫生质量管理,2019,26(02):43-46.[doi:10.13912/j.cnki.chqm.2019.26.2.14]

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北京市脑卒中诊疗质控问题分析与改进

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 第26卷期数: 2019年02期页码: 43-46 栏目: 医疗质量出版日期: 2019-03-28

作者:: 黄小钦任怡宋海庆陈飞王玉平; 首都医科大学宣武医院

关键词:: 脑卒中; 现场督查; 质量控制; 质控中心; 医疗质量

Keywords:: Stroke; Spot Supervision; Quality Control; Quality Control Center; Medical Quality

DOI:: 10.13912/j.cnki.chqm.2019.26.2.14

摘要:: 目的通过现场督查，发现医院脑卒中诊疗质量存在问题，提出改进意见。方法回顾性分析2015年-2017年北京市脑卒中诊疗质量现场督查结果。结果通过督查发现，各医院优秀率逐年上升，尤其连续3年参加督查的30家医院优秀率从2015年的36.7%上升到2017年的66.7%（P＜0.05）。建立脑卒中诊疗规范制度和应急预案的医院合格率逐年增加，合格率超过80%。开展脑卒中质量控制与改进的医院合格率逐年增加。但建立急诊卒中诊疗平台、脑卒中单元及诊疗团队的医院合格率低于70%；到院-给药时间<60min的医院合格率均较低。结论通过现场督查与指导，逐步规范了脑卒中诊疗质控体系，促进了脑卒中质控管理持续改进，但仍存在卒中救治团队建立不完善、DNT合格率较低等问题，需要持续改进。

Abstract:: Objective To reveal the problems in management of stroke diagnosis and treatment through spot supervision and propose effective measures for improvement. MethodsA retrospective analysis was conducted on the management data of stroke diagnosis and treatment through spot supervision in Beijing from 2015 to 2017. ResultsAfter quality control supervision, the excellence proportion of inspection results especially involved in 3-year-supervision about 30 hospitals had increased from the original 36.7% to 66.7% (P<0.05). The qualified rate of standardized stroke system and contingency schemes had improved year by year with the percentage over 80%. The qualified rate of the stroke quality controlling had increased year by year. However, the qualification rate of establishing stroke platform, units and teams were less than 70%. The qualification rate of hospitals with door-to-needle time (DNT) <60 minutes were relatively low.Conclusion Through on-site quality inspections and guidance, the stroke quality management system was gradually standardized. The continuous quality management and improvement of stroke was promoted. However, there was still a problem of imperfect establishment of the stroke rescue team and low DNT pass rate, which required continuous improvement.

参考文献/References:

［1］北京市卫生和计划生育委员会.北京市医疗专业质量控制和改进中心管理规定（2017版）［Z］.2017.

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更新日期/Last Update: 2019-03-28