持续改进之路——医院运用PDCA持续改进案例集

本书共收集来自5所医院临床、医技、行政职能部门的40个案例，这些持续改进案例，广泛运用了PDCA质量管理方法分析问题，解决问题，收到了明显的改进成效；这些PDCA案例覆盖到医院医疗管理、护理管理、药事管理、行政后勤管理等方方面面。案例的立意选择、文章的表述方法也极具启发意义。本书将对各级各类医院学会运用质量管理工具、提高医院持续改进能力具有较大的参考价值和借鉴作用。

目　录 第一章　持续改进之路概述及PDCA应用注意要点 ··································1 第一节　持续改进之路概述 ······································································1 第二节　PDCA应用注意要点 ····································································5 第二章　北京大学口腔医院案例 ································································7 第一节　北京大学口腔医院简介 ································································7 第二节　北京大学口腔医院PDCA制度 ······················································10 第三节　北京大学口腔医院PDCA案例 ······················································20 案例1　运用PDCA循环降低阶段性医疗纠纷发生率 ·······························20 案例2　运用PDCA循环持续提升我院抗菌药物使用管理值达标率 ·············28 案例3　运用PDCA循环降低正颌外科患者术后呕吐发生率 ······················37 案例4　运用PDCA循环缩短正颌外科患者术后留置胃管天数 ···················44 案例5　运用PDCA循环减少全口多颗瓷贴面粘接中的牙位混淆例数 ··········53 案例6　运用PDCA循环提高门诊护理人员四手配合开展率 ······················62 案例7　运用PDCA循环提高医务人员手卫生依从性 ·······························74 案例8　运用PDCA循环提高药品不良反应上报率 ··································80 案例9　运用PDCA循环降低住院患者药费负担 ·····································87 案例10　运用PDCA提高颅颌面内固定系统验收率 ································94 案例11　运用PDCA循环降低口腔综合治疗台手机动力不足故障发生率 ···105 第三章　宁夏医科大学总医院案例 ··························································113 第一节　宁夏医科大学总医院简介 ··························································113 第二节　宁夏医科大学总医院PDCA制度 ·················································115 第三节　宁夏医科大学总医院PDCA案例 ·················································117 案例1　运用PDCA循环规范医院危险化学品管理 ································117  案例2　运用PDCA管理工具降低急诊楼中央空调报修量 ·······················125 案例3　运用PDCA循环提高医院质量持续改进项目开展率 ····················132 案例4　运用PDCA方法确保医用耗材冷链存储的安全性 ·······················140 案例5　运用PDCA循环降低颅脑疾病致吞咽障碍患者误吸发生率 ···········147 案例6　运用PDCA循环持续改进医院临床被服洗涤配送服务质量 ···········153 案例7　运用PDCA循环规范胃肠外科肠外营养处方 ·····························162 　　　　7-1　改善胃肠外科TPN处方中二价阳离子浓度超标问题 ··········163 　　　　7-2　改善胃肠外科TPN处方中能量供给、热氮比普遍偏低问题 ·168 案例8　运用PDCA循环提高临床路径内涵质量 ···································172 案例9　运用PDCA提高诊断医师钼靶阅片识别乳腺癌的敏感性 ··············180 案例10　运用PDCA循环提高医院病房地面清洁质量 ···························185 第四章　北京电力医院案例 ····································································191 第一节　北京电力医院简介 ···································································191 第二节　北京电力医院PDCA制度 ··························································193 第三节　北京电力医院PDCA案例 ··························································194 案例1　运用FOCUS-PDCA改进检验危急值管理 ································194 案例2　应用PDCA规范病案首页的填写项目 ······································204 案例3　运用PDCA循环改进手术风险评估管理 ···································214 案例4　运用PDCA循环管理提高临床痰标本送检合格率 ·······················223 案例5　运用PDCA循环实现医院检查申请单无纸化 ·····························229 第五章　石家庄市妇产医院案例 ·····························································237 第一节　石家庄市妇产医院简介 ·····························································237 第二节　石家庄市妇产医院PDCA制度 ····················································239 第三节　石家庄市妇产医院PDCA案例 ····················································241 案例1　运用PDCA循环减少中央性前置胎盘手术患者难治性出血 ···········241 案例2　运用PDCA循环降低中转剖宫产率 ·········································250 案例3　运用PDCA循环提高门诊医师准时出诊率 ································258 案例4　运用PDCA循环加强药品效期管理 ·········································267 案例5　运用PDCA循环降低会阴侧切率 ············································274 案例6　运用PDCA循环降低接台手术延迟率 ······································282