Research On Medical Quality Control Of Clinical Departments Of A Third-level General Hospital In Hefei Based On PDCA Cycle

Objective: In this study,we explore the research and application of hospital quality management mode based on PDCA circle to provide an objective basis for using PDCA cycle mode in hospital clinical departments,to offer more accurate tools and accurate evaluation criteria,to promote the improvement of medical quality control in hospital clinical departmentsMethods: A third-level general hospital in Hefei was selected to implement the PDCA cycle in the medical quality control of the clinical department.Four stages of the PDCA cycleinclude p-planning stage,d-implementation stage,c-inspection stage,a-action stage and eight steps for medical quality control.Firstly,a large number of literatures should be read and consulted through the application of CNKI,wanfang database,weipu information database and Pub Med databases.Then,using Expert methodology,set the main seven clinical departments of medical quality evaluation index(doctors ability examination pass rate,medical documents writing quality qualified rate,clinical pathway with qualified rate,clinical rational use of qualified rate of drugs and medical adverse event reporting based objective has qualified rate,the medical quality,patient satisfaction).Finally,seven indicators of the hospital before PDCA cycle management were collected by self-control method,and the seven indicators were analyzed one year and two years later,for the purpose of studying the impact of PDCA cycle management on the medical quality of clinical departments.The chi-square test was used to compare the change of relevant indexes.Results: 1.Qualified rate of doctors' professional competence assessment: When the PDCA cycle was not implemented,the qualified rate of theoretical assessment was 93.4%.After one year and two years of implementation,it increased by 95.69% and 97.58% respectively.The comparison between the two groups had statistical significance(P < 0.05),There is no statistical difference between the non-implementation,implementation and implementation of the one-year group comparison and the implementation of the two-year group comparison(P>0.05).When the PDCA cycle was not implemented,the qualified rate of skill operation examination was 80.19%,which increased by 91.38% and 98.19% after one year and two years respectively(P<0.001).Skill assessment is greater than theoretical assessment in terms of passing rate.2.Qualified rate of writing medical instruments: When PDCA cycle was notimplemented,the qualified rate of Present medical records was 92.61%,which increased by 95.31% and 98.02% respectively after one year and two years of implementation(P < 0.001);when PDCA cycle was not implemented,the qualified rate of final medical records was 96.22%,which increased by 98.26% and 99.27% respectively after one year and two years of implementation(P < 0.001).The quality of Present medical records is higher than the quality of final medical records.3.Completion rate of clinical pathway: When the PDCA cycle was not implemented,the entry path rate was 65.47%,which increased by 74.22% and 85.12% after one year and two years respectively(P < 0.001);when the PDCA cycle was not implemented,the completion rate was 90.09%,which increased by 95.26% and 96.47% after one year and two years respectively(P < 0.001).The increase of entry path rate is larger than that of completion rate.4.Qualified rate of rational use of clinical drugs: When the PDCA cycle was not implemented,the eligible rate of rational use of antibiotics was 92.20%,which increased by 95.98% and 98.74% after one year and two years respectively(P < 0.001).When the PDCA cycle was not implemented,the eligible rate of rational use of auxiliary drugs was 79.42%,which increased by 87.53% and 93.57% after one year and two years respectively.Academic meaning(P<0.001).The rational use of auxiliary drugs is greater than the rational use of antibiotics.5.Qualified rate of reporting adverse medical events: When the PDCA cycle was not implemented,the punctuality rate of reporting time was 74.46%,which increased by 88.55% and 97.49% after one year and two years respectively(P < 0.001).When the PDCA cycle was not implemented,the accuracy rate of reporting event type was 50.22%,which increased by 70.03% and 88.40% after one year and two yearsrespectively(P < 0.001).The increase rate of accuracy of reported events is larger than that of reporting time.6.Rate of reaching the standard of basic indicators of medical quality: When PDCA cycle was not implemented,one of the basic indicators of medical quality(average hospitalization days,bed utilization rate,diagnostic coincidence rate of discharging and discharging,cure and improvement rate,rescue success rate,drug consumption ratio)one reached the standard,the rate of reaching the standard was 16.67%.After one year and two years of implementation,the rate of reaching the standard increased to 50%(three)and 83.33%(five).There was statistical significance in the comparison among the groups not implemented,implemented for one year and implemented for two years(P < 0.05),and there was statistical significance in the comparison between the groups not implemented and implemented for two years(P < 0.05).There is no statistical difference between the non-implementation,implementation and implementation of the one-year group comparison and the implementation of the two-year group comparison(P>0.05).7.Patient satisfaction: When the PDCA cycle was not implemented,the satisfaction rate of patients was 94.66%,which increased to 96.43% and 98.09% after one year and two years respectively(P < 0.001).Conclusion: 1.The main evaluation indexes of medical quality in clinical departments can reflect the difference between the implementation of PDCA circular quality management method.2.Hospital clinical departments of medical quality control work in the implementation of PDCA cycle,after,in its control methods,than before the PDCA cycle management approach can help doctors ability examination pass rate,medical documents writingquality qualified rate,clinical pathway with qualified rate,clinical rational use of qualified rate of drugs and medical adverse event reporting based objective has qualified rate,the medical quality,patient satisfaction aspects have improved,However,there are differences in the contribution of specific indicators in various aspects.3.The improvement of doctors 'theoretical knowledge and the achievement of the basic indicators of medical quality require the continuous implementation of PDCA circular quality management methods for at least one year,while taking into account other quality management methods.4.After the continuous improvement of the application of PDCA cycle in the medical quality control of clinical departments,the clinical medical quality can be significantly improved,and the quality management mode worth promoting in hospitals.