链接质量管理对医疗质量的影响：哈尔滨医科大学附属第四医院的一项比较研究。

The impact of link quality management on healthcare quality: a comparative study at The Fourth Hospital of Harbin Medical University.

作者信息

Liu Yi, Lang Zhenyu, Peng Xiaoxuan, Zhang Zhipeng, Fu Junwei, Zhou Chunhe

机构信息

Department of Medical, The Fourth Hospital of Harbin Medical University Harbin 150000, Heilongjiang, China.

Dean Office, The Fourth Hospital of Harbin Medical University Harbin 150000, Heilongjiang, China.

出版信息

Am J Transl Res. 2023 Sep 15;15(9):5930-5939. eCollection 2023.

PMID:37854209

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10579025/

Abstract

OBJECTIVE

To explore the impact of link quality management on healthcare quality.

METHODS

In 2021, The Fourth Hospital of Harbin Medical University followed various regulations and systems to manage the quality of hospital links. In 2022, the hospital upgraded and strengthened the quality management of hospital links. We collected and compared data from 2021 and 2022 on several observation indicators, including error rates in medical records, outpatient and inpatient numbers, surgical volumes, adverse event reporting, dispute complaints, inpatient medical records and outpatient prescriptions grading, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, admission rate of critically ill patients, workload index, work efficiency index, diagnostic quality index, treatment quality index, antimicrobial drug use rate, staff satisfaction rate, patient satisfaction rate, composite index, and Case Mix Index (CMI).

RESULTS

In 2021, the error rate of the first page of the general surgery medical records in The Fourth Hospital of Harbin Medical University was 27.91%, while in 2022 it significantly improved to 9.60% (P<0.05). The error rates of the main diagnosis, major surgical operations, other diagnoses, and other surgical operations on the medical records were all significantly different between 2021 and 2022 (all P<0.05). In 2022, the outpatient volume, inpatient volume, surgical volume, and adverse event reporting increased significantly compared to those in 2021, while the number of dispute complaints decreased significantly. The first-grade rate of inpatient medical records, first-grade rate of outpatient prescriptions, timely filing rate of medical records, inpatient satisfaction rate, average length of hospital stay, rate of level 3-4 surgeries, and admission rate of critically ill patients in 2022 were all significantly higher than those in 2021 (all P<0.05). The workload index, work efficiency index, diagnostic quality index, and treatment quality index in 2022 were all significantly higher than those in 2021 (all P<0.05). The outpatient antimicrobial drug use rate, emergency department antimicrobial drug use rate, and inpatient antimicrobial drug use rate in 2022 were significantly lower than those in 2021 (all P<0.05). In 2022, the satisfaction rate of medical staff was 93.57%, which was significantly higher than 81.16% in 2021 (P<0.05). In 2022, the patient satisfaction rate was 91.53%, which was significantly higher than 82.17% in 2021 (P<0.05). In 2022, the composite index and CMI values increased, while the error rate decreased significantly, as compared to those in 2021 (P<0.05).

CONCLUSION

After upgrading and strengthening the link quality management, The Fourth Hospital of Harbin Medical University has achieved significant improvements in management level, medical quality, technical level, and staff satisfaction.

摘要

目的

探讨环节质量管理对医疗质量的影响。

方法

2021年，哈尔滨医科大学附属第四医院遵循各项规章制度对医院环节质量进行管理。2022年，医院对医院环节质量管理进行升级强化。收集并比较2021年和2022年关于多项观察指标的数据，包括病历差错率、门诊和住院人数、手术量、不良事件报告、纠纷投诉、住院病历和门诊处方分级、病历及时归档率、住院患者满意度、平均住院日、三四级手术率、重症患者收治率、工作量指数、工作效率指数、诊断质量指数、治疗质量指数、抗菌药物使用率、员工满意度、患者满意度、综合指数以及病例组合指数（CMI）。

结果

2021年，哈尔滨医科大学附属第四医院普通外科病历首页差错率为27.91%，而2022年显著改善至9.60%（P<0.05）。2021年和2022年病历上主要诊断、主要手术操作、其他诊断以及其他手术操作的差错率均有显著差异（均P<0.05）。2022年，门诊量、住院量、手术量及不良事件报告与2021年相比均显著增加，而纠纷投诉数量显著减少。2022年住院病历甲级率、门诊处方甲级率、病历及时归档率、住院患者满意度、平均住院日、三四级手术率以及重症患者收治率均显著高于2021年（均P<0.05）。2022年工作量指数、工作效率指数、诊断质量指数及治疗质量指数均显著高于2021年（均P<0.05）。2022年门诊抗菌药物使用率、急诊抗菌药物使用率及住院抗菌药物使用率均显著低于2021年（均P<0.05）。2022年医务人员满意度为93.57%，显著高于2021年的81.16%（P<0.05）。2022年患者满意度为91.53%，显著高于2021年的82.17%（P<0.05）。与2021年相比，2022年综合指数和CMI值升高，差错率显著降低（P<0.05）。