Study On The Establishment And Application Of The Quality-evaluation Model Of ACS

ObjectivesThis purpose of the study is to attach great importance to quality monitoring and quantitative evaluation on the diagnosis and treatment of acute coronary syndrome (ACS), and to construct the quality-evaluation model of ACS on the basis of summary and analysis on the international and domestic ACS guidelines and quality control standard of single disease; In order to analyse the rationality and feasibility of the constructed model, this study wants to evaluate and compare the diagnosis and treatment quality in 15 tertiary hospitals in Beijing with the quality-evaluation model, aiming to provide decision-making basis for the administrative department of health and hospital managers to manage the quality of single disease.ContentsThis paper constructed the quality-evaluation model of ST elevation myocardial infarction(STEMI)and non-ST-elevation acute coronary syndromes (NSTE-ACS) based on the key events and time node on the process of diagnosis and treatment; the paper calculated 15 tertiary hospitals’comprehensive quality to analysis the rationality and feasibility of this appraisal system; and put forward suggestions at last.MethodsThis study reviewed international and domestic ACS guidelines and quality control standard of single diseases, and summarized the basic experience of foreign quality-evaluation model of ACS;The quality-evaluation model has been formatted with the document analysis method and expert consultation method, with the indicators weighted by analytic hierarchy process;By collecting the data in 15 hospitals, we can get the values of indicators, then can synthetically evaluate and compare the diagnosis and treatment quality in these 15 hospitals with the method of WRSR.Results1. The research has constructed a set of science and practical quality-evaluation model of STEMI and NSTE-ACS, and the model of STEMI has included 5 dimensions,14 two level targets,49 three level targets, while the model of NSTE-ACS has included 5 dimensions,14 two level targets,47three level targets.2. The result of comprehensive evaluation is:while diagnosing and treating the cases of STEMI,there are some differences between the clinical guidelines and the actual level in the inspection, evaluation, reperfusion treatment and drug therapy. Also, there are some differences in the diagnosis and treatment quality among different hospitals. All hospitals are consistent on the five dimension—inspection, evaluation, reperfusion treatment, drug therapy and prognosis. The constructed quality-evaluation model of ACS can reflect objectively and steadily the diagnosis and treatment level and quality of hospitals.Conclusions1. This study developed the quality-evaluation model of STEMI and NSTE-ACS with five dimension—inspection, evaluation, reperfusion treatment, drug therapy and prognosis. They have the scientific, feasibility, commeasurable characteristic with actual development situation match case.2. The quality-evaluation model was advantageous to reflect the diagnosis and treatment quality of cardiovascular medicine comprehensively and dynamically, and part reflect hospital’s overall management level, so as to provide operating methods in improving hospital diagnosis and treatment quality.RecommendationsThis dissertation proposed four recommendations as follows:strengthening the construction of emergency green channel, and optimizing medical process; improving professional ability of medical staffs; consummateing the incentive mechanism and accountability mechanism, and enhancing the level of operational standardization of medical staffs; promoting quality management for a specific disease, and improving the level of medical quality.