目的 了解國內醫院品質管理圈（品管圈）活動的發展現況，為品管圈活動的進一步推廣和研究提供依據。 方法 2012年2月－6月采用文獻研究法，檢索公開發表于國內學術期刊的有關品管圈活動的所有文獻，并閱讀分析全文。 結果 共收集符合要求的文獻125篇，文獻主要來源于我國東部地區、類型以回顧性分析為主，主題內容側重護理質量與藥事服務管理。 結論 我國醫院品管圈活動發展迅速，涉及面廣，但研究方法、研究內容如社區發展等方面仍亟待進一步加強。
Objective To explore the application of quality control circle in reducing the same-day cancellation rate of day surgery. Methods A quality control circle team was set up, and determined the theme of reducing the same-day cancellation rate of day surgery. A survey was conducted among all patients who had made appointments for day surgeries at the First Affiliated Hospital of the Air Force Military Medical University between August and October 2023. The number of patients who cancelled their surgeries on the day and the reasons for their cancellations were recorded. Based on the ten steps of the quality control circle, relevant measures and improvement processes were formulated. In March 2024, the same-day cancellation rate of day surgery after the quality control circle activity was analyzed. Results The same-day cancellation rate decreased from 2.39% to 0.67%, the target achievement rate was 135.43%, and the progress rate was 71.97%. Conclusion The quality control circle activity can effectively reduce the same-day cancellation rate of day surgery.
Objective To investigate the effect of quality control circle in reducing ventilator-associated pneumonia in Pediatric Intensive Care Unit (PICU). Methods A total of 1 249 child patients who underwent mechanical ventilation between January and December 2013 were chosen as the control group, and they accepted routine management. Another 1 208 child patients treated between January and December 2014 were selected as the observation group, and quality control circle was adopted. The compliance of ventilator care bundles, the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia were compared between the two groups. Results Compared with the control group, compliance of ventilator care bundles was higher in the observation group (P<0.01), the duration of mechanical ventilation was shorter [(6.9±2.4) daysvs. (4.6±2.2) days], the length of PICU stay was shorter [(9.2±3.1) daysvs. (7.7±2.4) days], and the incidence of ventilator-associated pneumonia was lower (22.4‰vs. 9.1‰) (P<0.05). Conclusion Application of quality control circle can significantly promote the compliance of ventilator care bundles, and decrease the duration of mechanical ventilation, the length of PICU stay and the incidence of ventilator-associated pneumonia.
Objective To evaluate the application effect of quality control circle (QCC) in improving the number of cases received in the follow-up management of chronic kidney disease (CKD). Methods The outpatient and inpatient CKD patients who were filed in the CKD follow-up management center of West China Hospital of Sichuan University from March 10 to October 10, 2020 were selected. We analyzed the reasons that affected CKD patients’ willingness to file by carrying out QCC, improved the case collection by establishing standardized processes, broadened the collection channels, established a collective team, strengthened training management and education of CKD patients and their families, so as to increase the number of cases received in CKD follow-up management. Then, we observed the score of active ability of QCC members before and after this activity. Results After the implementation of QCC activities, the number of follow-up cases increased from 8 per month to 15 per month. The target achievement rate was 140%, and the progress rate was 87.5%. The ability of all circle members in the evaluation indicators of team training has been improved. Conclusions QCC activity can effectively improve the number of cases received in CKD follow-up management. It is helpful for the medical staff to provide better disease management for CKD patients.
Objective To explore the effect of sequential nutritional intervention mode on improving early postoperative nutritional status in patients with gastric cancer. Methods A total of 30 patients who underwent radical gastrectomy for gastric cancer in the Department of Gastrointestinal Surgery, Ningbo No.2 Hospital between June and August 2022 were selected as the tiral group by convenience sampling, and another 30 patients who underwent radical gastrectomy for gastric cancer between September 2021 and January 2022 were retrospectively selected as the control group. The trial group received the sequential nutritional intervention model constructed by quality control circle activities in the Department of Gastrointestinal Surgery, and the control group received routine nutritional support. The nutritional status and quality of life of the two groups were evaluated one month after discharge. Results Before intervention, there was no statistically significant difference in the Patient-Generated Subjective Global Assessment (PG-SGA) score, serum albumin, serum prealbumin, body weight, or Quality of Life Questionnaire Core 30 (QLQ C30) score between the two groups (P>0.05). After intervention, both groups showed improvements in PG-SGA score, serum albumin, and serum prealbumin compared to before intervention (P<0.05); there was no significant change in body weight in the trial group (P>0.05), while the control group experienced a decrease in body weight (P<0.05); the trial group showed an improvement in QLQ C30 score (P<0.05), whereas the control group did not show significant change in QLQ C30 score (P>0.05). Compared to the control group after intervention, the trial group showed better PG-SGA score (7.97±1.65 vs. 8.83±1.26), serum albumin level [(40.61±1.30) vs. (39.93±0.78) g/L], serum prealbumin level [(0.266±0.030) vs. (0.229±0.051) g/L], body weight [(63.12±7.39) vs. (58.17±9.18) kg], and QLQ C30 score (62.63±9.01 vs. 57.23±7.13), with all differences being statistically significant (P<0.05). Conclusion Sequential nutritional intervention model is helpful to improve the early nutritional status and quality of life of patients after radical gastrectomy, and has clinical promotion value.
ObjectiveTo study the effect of quality control circle activities on reducing the risk of observed patients. MethodBy carrying out the quality control circle, it was done that confirming the subject, grasping the risk of observed patients, setting a goal, analyzing the risk factors of existing problems, finding out the real reasons, drawing up and actualizing the countermeasures. ResultsAfter carrying out the quality control circle, the main risk factor, emergency rescue, of observed patients was ameliorated significantly (P < 0.05). The risk was declined from 0.41% to 0.14% (P < 0.05). The self-evaluation of circle members was improved (P < 0.001). ConclusionBy the quality control circle, it is actualized effectively that reducing the risk of observed patients and improving the overall qualities of nurses. This thing is helpful to improve the quality of nursing.
Objective To observe the effect of quality control circle (QCC) management tools to improve the electronic medical record timely writing rate. Methods Between June 2014 and January 2015, we used QCC to manage electronic medical record timely writing rate. By determining the subjects, investigation of the status quo, factor analysis, and and formulation and implementation of strategies, we tried to improve the electronic medical record timely writing rate. Results After QCC implementation, electronic medical records untimely rate dropped from 39.6% to 13.8%, with surgical departments dropping from 45.6% to 15.2% and non-surgical departments from 33.6% to 12.4%. Target compliance rate reached 124.04%, of which the untimely rate of nursing records and the overtime rate of rescue records were both reduced to 0. Quality management methods, team cohesion, confidence, personal comprehensive ability and problem-solving ability all improved significantly. Conclusions The timeliness of electronic medical records management has its importance and urgency. We should make good use QCC management to ensure timely electronic medical records writing.
ObjectiveTo improve activities of daily living (referring to Barthel Index) in the older inpatients.MethodsIn January 2016, a quality control circle (QCC) was established. According to 10 steps in activity of QCC, we figured out the causes of low Barthel Index score in older inpatients by using Plato method and Fishbone Diagram which were common methods of QCC. In addition, we designed and implemented a rectification program to improve Barthel Index score.ResultsAfter intervention of QCC, the average Barthel Index score of the older inpatients increased from 72.40±6.42 to 89.30±5.87 with a statistical difference (P<0.01); the satisfaction percent of hospitalized patients increased from 94.5% to 98.7% with a statistical difference (P<0.01). The percentage of registered nurses whose theoretical test score were over 90 increased from 57% to 88% (P<0.01) and the satisfaction percent of nurses increased from 90.5% to 95.6% (P<0.01). Moreover, the member’s ability of learning, discovery, analysis and problem solving, communication, application of QCC skills were improved.ConclusionThe application of QCC activities will increase older inpatients’ Barthel Index score, improve the satisfaction of patients and nursing staff, and enhance the members’ ability of solving problems by using QCC skills.
Objective To improve the model of hospital-community integrated service of day surgery through quality control circle (QCC). Methods To optimize the community follow-up management of day surgery patients, we used QCC between March and August 2015 to find out the real reasons for community follow-up problems in day surgery patients and developed and implemented corresponding countermeasures. Comparison of health education, postoperative follow-up of dressing changes, and doctor-patient satisfaction assessment before and after the implementation of the model of hospital-community integrated service of day surgery (September 2014-February 2015vs. September 2015-February 2016) was then performed. Results After QCC implementation, the average number of dressing changes in the hospital was reduced from 4.58±0.95 to 1.18±0.39 (t=181.194,P<0.001). The average number of dressing changes in the community increased from 1.42±0.52 to 4.32±0.88 (t=–146.245,P<0.001). The average number of health consultation increased from 0.85±0.38 to 6.39±1.20 (t=–177.096,P<0.001). The satisfaction assessment after QCC implementation among doctors, nurses and patients also significantly increased (P<0.01). Conclusion Applying QCC can improve the model of hospital-community integrated service of day surgery and have remarkable effects on postoperative rehabilitation and patients’ satisfaction.