Objective To explore the application value of quality control tools in rehabilitation clinical pathway management.Methods Quality control tools, such as PDCA circulation, fishbone chart, Gantt chart and 5W1H, were used to analyze the clinical path implements, to find out the reasons for the low rate of clinical pathway entry and completion, and to make continuous improvement. The data from July, 2013 to June, 2018 were divided into ten boxes as half-a-year. The former five boxes were as control group, and the latter five boxes were as study group. Results There was no significant difference in the number of discharged patients between the study group and the control group (t < 2.260, P > 0.05), but there was significant difference between the two groups in the number of patients entering the rehabilitation, variation and completion in the rehabilitation and the total clinical pathway (t > 6.501, P < 0.001). There were significant differences in the rate of entering total clinical pathway, and the rate of the variation and the completion of total clinical pathway (χ2 > 10.973, P < 0.001). Conclusion Application of quality control tools can expand the implement of clinical pathway, improve the rate of entry and completion in clinical pathway, and reduce the variation.
LI Man
,
ZHANG Shu-yan
,
CHEN Shuang
,
ZHU Ping
. Application of Quality Control Tools in Rehabilitation Clinical Pathway Management[J]. Chinese Journal of Rehabilitation Theory and Practice, 2019
, 25(5)
: 602
-607
.
DOI: 10.3969/j.issn.1006-9771.2019.05.020
1 国家卫生计生委. 国家卫生计生委办公厅关于切实做好临床路径管理工作的通知〔国卫办医函(2013)210 号〕 [EB/OL]. (2013-09-06). http://www.nhfpc.gov.cn/zwgk/lclj/201309/b5484320ef824420ac33439508bbdcc5.shtml.
2 国家卫计委. 关于印发进一步改善医疗服务行动计划的通知〔国卫医发(2015)2号〕[EB/OL]. (2015-01-12). http://www.nhfpc.gov.cn/yzygj/s3593g/201501/5584853cfa254d1aa4 e38de0700891fa.shtml.
3 HirokiF. Effect on completion of clinical pathway for improving clinical indicator: cases of hospital stay, mortality rate, and comprehensive-volume ratio [J]. J Med Syst, 2017, 41(12): 206.
4 SanderO.The effectiveness of a clinical pathway in liver surgery: a case-control study [J]. J Gastrointest Surg, 2018, 22(4): 684-694.
5 李曼,朱平,陈爽,等.康复临床路径的实施效果[J]. 中国康复理论与实践, 2017, 23(7): 855-858.
6 田野. 神奇的医院管理工具——鱼骨图[J]. 当代医学, 2004(2): 26-27.
7 刘军跃,李远志. 运用PDCA循环实现绩效管理系统的有效沟通[J]. 商业研究, 2006, 49(23): 41-43.
8 王晓红,郭华,何成奇. 颈椎病康复临床路径[J]. 华西医学, 2013, 28(2): 215-220.
9 任荣政,丁年青. ESP教学“5W1H”要素分析[J]. 外语界, 2012(2): 58-64.
10 曾莉芬. 工业品品牌推广的5W1H分析[J]. 商场现代化, 2007(32): 114-115.
11 中国(双法)项目管理研究委员会. 中国项目管理知识体系[M]. 北京:电子工业出版社, 2006: 245.
12 陈璐,左桐,郑钟洁. 甘特图在疾病预防控制项目中的应用[J]. 中国卫生质量管理, 2013, 20(1): 103-104.
13 王平根,符祥敏,吴葳. 一种基于电子病历的首页审核模式介绍[J]. 中国病案, 2015, 16(2): 48-50.
14 陈忠兰,宁宁,李明凤. 临床路径变异研究新进展[J]. 中国医院管理, 2011, 31(2): 28-29.
15 李建华,隗和红,付立臣. 临床路径管理在短暂性脑缺血患者中的初步应用及变异分析[J]. 中国病案, 2014, 15(6): 38-40.
16 宋丽,范理宏. 变异管理在临床路径持续改进中的作用[J]. 中国卫生质量管理, 2011, 18(2): 30-33.
17 王佩琪,裴玉玲. 临床路径的应用现状及实施意义[J]. 中外医疗, 2013(7): 191-192.
18 司马俊,马亚娜,徐德武. 基于临床路径的医疗质量管理效果提升途径研究[J]. 航空航天医学杂志, 2014, 25(8): 1143-1148.
19 王静,刘庭芳. 现代医院三维工具合成化应用的逻辑关联性探讨及其应用[J]. 中国医院, 2016, 20(5): 54-57.
20 常虹,袭燕. 软体类管理工具在我国新一轮医院评审中的应用探析[J]. 才智, 2015(17): 303-304.
21 阳桃鲜,李锐,李蕊. 质量管理工具在院科两级质量管理中的运用[J]. 当代护士, 2016(9): 181-183.
22 郑西川,于广军,谭申生. 临床路径电子化应用与临床知识库建设实践[J]. 中国卫生信息管理杂志, 2011, 8(5): 21-25.
23 沈崇德. 基于电子病历的数字化临床路径管理[J]. 中国卫生信息管理杂志, 2012, 9(3): 18-20.
24 王玲欢,郑伟平,秦银娟,等. 电子临床路径管理的应用与效果分析[J]. 医院管理论坛, 2013, 30(4): 29-31.
25 曹慕慧. 临床路径实施过程中的变异及其对策的探讨[J]. 中国病案, 2014, 16(3): 24-25.
