腹腔镜胆囊切除临床路径的持续改进  

Continuous Improvement of Laparoscopic Cholecystectomy Clinical Pathway

作　　者：张春[1] 修典荣[1] 付卫[1] 徐智[1] 马朝来[1] 胡牧[1] 

机构地区：[1]北京大学第三医院,北京100191

出　　处：《中国医院管理》2012年第7期28-30,共3页Chinese Hospital Management

基　　金：北京大学医学部"985工程"二期建设项目(985205939)

摘　　要：目的探讨利用戴明环对腹腔镜胆囊切除的临床路径进行持续改进的效果。方法总结分析2008年3月—2010年12月北京某三级甲等医院腹腔镜胆囊切除临床路径的数据。在路径的实施过程中使用戴明环的原理遵照既定的临床路径方案实施,在实施方案过程中发现路径的问题,并进行分析和总结,解决问题,修正路径后继续实施。结果近3年共1 861例患者进行筛选,1 539例进入路径,1 408例完成路径,共131例退出路径,退出率为8.5%。在戴明环原理的指导下,逐步改进流程,退出率由14.5%逐步降至1.4%。结论按照戴明环的原理持续改进腹腔镜胆囊切除临床路径,可以使之更加符合临床实际,促进路径发展。Objective To explore the effect of improvement for laparoscopic cholecystectomy clinical pathway by Deming Cycle. Methods Analyzing laparoscopic cholecystectomy data from March 2008 to December 2010 in a large hos- pital in Beijing. In the path of the implementation process in accordance with the principles of Deming Cycle, clinical pathway program is established, and problems are found, analyzed and summarized. Results During these 3 years, 1 861 cases were screened. 1 539 cases got into the path and 1 408 cases completed it, 131 cases exited with 8.5% quit rate. Under the guidance of the Deming Cycle principles, the process should be gradually improved. Exit rate of 14.5% gradually approached 1.4%. Conclusion Deming Cycle continuous improvement can make clinical pathway of la- paroscopic cholecystectomy meet the objective reality, and promote the path development.

关 键 词：腹腔镜胆囊切除 临床路径 戴明环 诊断相关组 

分 类 号：R197.323[医药卫生—卫生事业管理]