基于信息管理系统的急性心梗医疗质量改进分析  

The Analysis of the Medical Quality Improvement on Acute Myocardial Infarction Based on Information Management System

作　　者：陈维进[1] 王雨来[1] 王玉霞[1] 张凯[1] 张华峻[1] 吴雪琴 兰艳[1] CHEN Weijin;WANG Yulai;WANG Yuxia(EDong Healthcare Huangshi Central Hospital,Huangshi,Hubei,435000,China)

机构地区：[1]鄂东医疗集团黄石市中心医院

出　　处：《中国卫生质量管理》2019年第3期86-89,共4页Chinese Health Quality Management

摘　　要：目的开发JCI-CCPC团队照护与患者信息管理系统,探讨导入CCPC-AMI前后STEMI医疗质量的改进效果。方法运用回顾性对比分析法,选择导入后2017年1月-6月77例患者和导入前2015年1月-6月51例患者为实验组和对照组。以患者到达急诊科至首次心电图接诊时间、到达急诊科至确诊STEMI时间、到达急诊科至采血时间、门球时间、住院天数、均次费用、是否院内AMI复发、是否院内再次PCI和转归等为评价指标。结果与对照组比较,实验组在患者到达急诊科至首次心电图接诊时间、至采血时间、门球时间、住院天数、门球时间90分钟达标率、院内AMI复发率、院内再次PCI率和患者转归等方面均有统计学差异,均次费用、至确诊急性心肌梗死时间无统计学差异。结论基于信息管理系统的CCPC-AMI可显著缩短STEMI门球时间,住院时间、院内AMI复发率、院内再次PCI率和患者病死率均显著下降,但均次费用改善效果不显著。Objective To develop JCI-CCPC team care and patient information management system,and to explore the improvement effect of STEMI medical quality before and after CCPC-AMI.Methods A retrospective comparative analysis method was used to select 77 patients from January to June 2017 as the experimental group,and 51 patients from January to June 2015 before the introduction as the control group.The evaluate indicators included time durationfrom the patient arriving in the emergency department to the first ECG,time durationfrom the arriving in the emergency department to the confirmation of the STEMI,time duration from the arriving in the emergency department to the blood collection,the door to balloon time,the length of stay,the average cost,whether the hospital has an AMI recurrence,whether the hospital has another PCI and the clinical outcome.Results Compared with the control group,the experimental group had statistical significantly difference on time duration from the patient arriving in the emergency department to the first ECG,to the confirmation of the STEMI,to the blood collection,the door to balloon time,the length of stay,the average cost,whether the hospital has an AMI recurrence,whether the hospital has another PCI and the patient mortality rate.However,there was no statistical difference on the average cost.Conclusion The CCPC-AMI based on the information management system can significantly shorten the STEMI door to balloon time.The hospitalization time,the in-hospital AMI recurrence rate,the in-hospital PCI recurrence rate and the patient mortality rate were all significantly reduced,but the average cost improvement effect was not significant.

关 键 词：CCPC-AMI 急性ST段抬高心肌梗死 质量改进 信息管理系统 

分 类 号：R197.3[医药卫生—卫生事业管理]