Research And Application Of Hospital Quality Management Mode Based On PDCA Circle

ObjectiveBased on the analysis of the quality management model of the hospital,starting with the basic quality,procedure quality and terminal quality,and regarding the key quality management projects and crucial procedures as the breakthrough point,this study aims to explore the application and efficiency of PDCA cycle-based quality management model in hospital quality management and continuous improvement,afford lessons for promotion and application of the hospital quality management model and provide a reference for improvement of the hospital quality management level.Methods1.Literature research method: Through the following databases,including CNKI,Wan Fang and Pubmed,relevant literatures were refered to provide the theoretical basis and guiding methods for this study,of which "medical quality","hospital quality","quality management","hospital management","PDCA","continuous quality improvement" were as the keywords.2.Cases study method: A class-three hospital in Shanxi Province was selected as a case for studying in this paper.Through the analysis and research on the PDCA cycle-based quality management model,this paper analyzes and compares the quality improvement effect before and after the application of quality management model.3.PDCA cycle method: Conduct hospital quality management according to the order of Plan,Do,Check and Action,and improve quality continuously through repetitive circulation and stepwise rising process.4.Comprehensive index method: Through establishing the original database matrix of quality evaluation index of a certain hospital from 2010 to 2015,conduct indexation,calculate synthetic index and conduct vertical comprehensive evaluation towards the performance of quality management mode in that hospital according to the index.Results1.The hospital explored a hospital quality management model with three levels of quality control system as the organizational support,PDCA as the continuous quality improvement method,and diversified operation mode.2.PDCA circulation is widely used in the hospital foundation,procedure and terminal quality management,and promotes the continuous improvement of hospital quality.For example,PDCA circulation improves the hand hygiene compliance of medical staff remarkably,and the hand hygiene compliance of medical staff in NICU is increased from 68% to 81.5%.3.The basic operation of hospital quality management mode(1)Work intensity: The number of outpatient visits was 624973 in 2010 and 111697 in 2015,the year-on-year growth of which was 78.72%;The number of discharged patients was 37768 in 2010 an 44300 in 2015,the year-on-year growth of which was 17.3%;The total number of operations was 9786 in 2010 and 17511 in 2015,the year-on-year growth of which was 78.94%.The workload laid on the shoulders of medical staff is increasing year by year.(2)Work efficiency: The average length of stay of that hospital was 7.43 days in 2010 and 6.91 days in 2015,the year-on-year decline of which was 7%;Bed utilization ration was 108.12% in 2010 and 97.42% in 2015,the year-on-year decline of which was 9.90%;Bed turnover number had been larger than the reference value in national 3A hospitals six years in a row(≥17 times/year).The work efficiency is high.(3)Medical quality: During the past 6 years in that hospital,the curing rate had increased 0.66% and the death rate had decreased 36.84%.Successful rescue rate of critical patients had risen 2.58%,the hospital infection rate had declined 0.39% and the other quality index was all above the 3A hospital’s standard.Treatment quality improves step by step,quality of diagnosis remains stable and hospital infection control was put into practice.(4)Benefits: During the past 6 years,the average medical costs for outpatients and discharged patients have gained 137.47 yuan and 1919.98 yuan respectively.These two costs increase slowly and maintain in a rather reasonable growth range;the proportion of drug revenue accounted for total revenue has dropped 4.34% and overall benefit is good.(5)Patient satisfaction: During the past 6 years,the satisfaction levels of outpatients and discharged patients were both above 92% and the evaluation results was good.(6)Scientific achievements: During the past 6 years,the numbers of papers published in national and provincial journals and SCI had increased 28,36,4 respectively,showing a good trend.4.The comprehensive evaluation of hospital quality management mode operating effectsThe hospital quality synthetic index showed an upper trend year by year during 2010-2015 and the best performance happened in 2015 with the index of 11.5202,followed by 2014 with 9.6346,2013 with 7.5124,2012 with 7.3190,2011 with 7.2527 and 2010 with 7.0696.Compared with year 2011,year 2015 has witnessed a 4.45% growth in hospital quality synthetic index.The synthetic index at good quality management operation phase during 2013-2015 was larger than those at hospital quality construction phase during 2010-2012.ConclusionTaking the three-level quality control management system as a prerequisite,the basic quality,link quality and final quality as the starting point,and focusing on key quality management projects and their key links,the quality management model based on PDCA cycle works well in hospital,and help to improve the overall level of hospital quality management,which is worthy for the peer hospital taking as the reference of quality management mode.