Compliance Of Scheduled Visits On Patients With Endoscopic Sinus Surgery:A Quality Control Circles-based Study

Objectives Our goal was to further track compliance of scheduled visits on patients with endoscopic sinus surgery, and to correctly evaluate the theory and methods by using tools for quality management or quality control circles(QCC),as well as the compliance of scheduled visits on patients which performed educational initiatives of quality control circles(QCC).Methods In this subject,the QCC panel(also known as optimal circles) was assembled in July2014,which was consisted of 13 otolaryngology head and neck surgery nurses who had volunteered for the panel.our theme was to improve the compliance of scheduled visits on patients with endoscopic sinus surgery.Based on needs of QCC are implemented,we collected 140 patients who had endoscopic sinus surgery in our hospital and fulfilled inclusion and exclusion criteria between July, 2014 and July, 2015,and 35 patients were enrolled in each group, with QCC was performed and standardly using tools for quality management or QCC.On the one hand,we give routine nursing and management to the control group patients after endoscopic sinus surgery at scheduled visits, we made a cross-sectional study which was conducted by providing the control group patients with telephone follow-up and questionnaire survey at six months after their operation,entire team members use brainstorming method to draw the fishbone diagram around five aspects scored separately: man, material, material, method and ring,then we analyzed the reason of low compliance in patients with nasal endoscopic surgery,and then we used Pareto curve finding out the root cause of low compliance of scheduled visits on patients,finally we put forward effective and innovative countermeasures.On the other hand,the intervention group was formed by inpatients from May, 2015 to July, 2015.And this group underwent the implementation of standardized health education.Meanwhile we optimized the humanized referral process, then we established timely,efficient,personalized information exchange and communication mechanism between peer doctor-patient, countermeasure, determine the sequence of system implementation.In all,we implemented all of these established strategies sequentially, systematically and comprehensively.Data were analyzed by one,two-way and repeated measures ANOVAs,and then,we compared and analyzed these data between two groups to evaluate the effectiveness of intervention measures.Results1.The theory and methods of QCC management can help us effectively solve the problem that we can analyze the root causes of compliance of scheduled visits on patients with endoscopic sinus surgery, these methods are reasonable,and can be extended to study the compliance in other suitable diseases’ follow-up.2.The implementation of QCC can Improve not only the awareness of referral of patients after Endoscopic Sinus surgery but also the compliance of discharged patients referral.We found that compliance of scheduled visits on patients with endoscopic sinus surgery improve from 37.14% to 84.28%. As compared without implementation of QCC, there is a Significantly different,P < 0.05.Meanwhile, The implementation of QCC enhanced care team whose communication coordination and problem solving skills were Improved,strengthened the health care responsibility and passion for work, raised the value of our own professional identity.Patients and health care professionals and win-win results have been achieved.3. In the intervention group we found a significant difference in growth rates of awareness of health education in patients with nasal endoscopy. Control group patients after Endoscopic Sinus Surgery number of physician visits is 26 cases, Intervention group patients after Endoscopic Sinus Surgery number of physician visits is 59 cases whose number of cases is significantly higher than control group. Health education awareness raised from 59.65 points to 89.25 points. Intervention group is significantly higher than control group.The satisfaction of Patients leaving hospital raised from 90.54% points to93.44%.In a word,Using the method of management of quality control circle is targeted and effective solutions.4. QC circle activity to reduce recurrence of the disease in patients after Endoscopic Sinus surgery has a positive effect.Preoperative analysis,chronic rhinosinusitis with nasal polyps and chronic nasal sinusitis with nasal polypsand nasal polyps in patients with simple multi symptom scores were higher than in the control group. But based on management quality control circle activity after the intervention group, With prolonged postoperative within 48 hours after the operation, operation period of headache, mouth dry, my eyes overflow with tears and sleep disturbance of all the patients are quickly showing a decreasing trend.Chronic rhinosinusitis with nasal polyps and not simply effect in alleviating sleep disorder in patients with nasal polyp.In short, based on the management of quality control circle, it can be extended to other appropriate disease doctor compliance. Quality control circle activity can not only improve the quality of health care personnel, may also improve compliance of the referral of patients after Endoscopic Sinus surgery. Quality control circle health for patients after health education intervention can improve knowledge, improving patient understanding of disease diagnosis, treatment and rehabilitation, in order to reduce the recurrence rate of disease and the rate of rehospitalization provide effective nursing care strategy.