The Application Of Tracking Methodology Combined With FMEA In The Management Of High-value Consumables In Implant Operation In A "Grade A Class Three" Oral Hospital

Objective:Through tracking methodology combined with failure mode and effect analysis,the management of high-value consumables in implant operation in a “Grade A Class Three” oral hospital was tracked and monitored,and the improvement measures were made to the problems existing in the management.To establish the quality management method of high-value consumables in dental implant operation,to improve the working efficiency and quality of medical staff,and to ensure the safety of patients’ medical treatment.Methods:In this study,tracking methodology combined with failure mode and effect analysis was used to evaluate the risk of the management of high-value consumables in planting operation.The main failure modes were found out by risk priority number,and targeted improvement measures were established to optimize and improve traceable management procedure and implement it.The tracking inspection team was established and the tracking route was determined in order to check its effect.From January to October 2015,562 samples of the information on the use of high-value consumables in stage I implant operation from a “Grade A Class Three” oral hospital of Jiangxi Province were selected as the sample size before the implementation of intervention measures.From January 2016 to December 2017,1456 samples were selected as the sample size after the implementation of intervention measures(the sample size was 694 one year after implementation and 762 two years after implementation.).The total of 66 medical staff engaged in the management of high-value consumables in implant operation were selected as the objects of investigation.The RPN score of failure mode in management,the qualified rate of management benefit evaluation indexes and the satisfaction of medical staff were compared before,1 year and 2 year after the implementation of intervention measures.Descriptive analysis,Levene’s test,Analysis of Variance,Bonfferoni test and chi-square test were used to analyze the data.Results:1、The main failure modes in the management of high-value consumables in implant operation are as follows: information recording error(226.00±22.70),difficulty in tracing back(210.27±27.65),imperfection of management system(168.67±34.37),high arbitrariness of accounting(131.07±19.87),poor consciousness of reporting adverse events(127.87±28.60)and so on.After 1 year and 2 years of the implementation of intervention measures,the RPN values of the 5main failure modes were significantly decreased,and the difference was statistically significant(P<0.05),There wasn’t significant difference between 2 years and 1 year after the implementation of intervention measures(P > 0.05).2、After 1 year and 2 years of the implementation of intervention measures,the qualified rate of work efficiency indexes and work quality indexes in the management benefit were significantly improved,the difference was statistically significant(P <0.05);However,there wasn’t significant difference between 2 years and 1 year after the implementation of intervention measures(P > 0.05).3、After 1 year and 2 years of the implementation of intervention measures,the satisfactions of management mode,usage process,work efficiency,information record and overall satisfaction were significantly improved,and the difference was statistically significant(P<0.05).while the satisfactions of the links connection,quality control and supervision,pricing fee,file management,adverse event reporting process,information tracing were improved,but the difference wasn’t statistically significant(P > 0.05).There wasn’t significant difference between 2 years and 1 year after the implementation of intervention measures(P > 0.05).Conclusion:1 、 In this study,the main failure modes in the management of high-value consumables in implant operation was as follows: information recording error,difficulty in tracing back,imperfection of management system,high arbitrariness of accounting,poor consciousness of reporting adverse events and so on.2 、 Tracking methodology combined with FMEA intervention can effectively improve the management quality of high-value consumables,work efficiency and the satisfaction with medical staff,and make the indexes continuously improved.3、The reengineering and optimization of the management process of high-value consumables in implant operation,which can realize the controllable,checkable and traceable management of high-value consumables in implant operation.