以精细化管理助推基层医院急诊急救体系建设的研究  

Application of Refind Management in the Construction of Emergency System in basic Hospital

作　　者：孙彦荣 张莉莉 李海洋 王静 斯重阳[2] SUN Yanrong;ZHANG Lili;LI Haiyang;WANG Jing;SI Chongyang(Central Hospital of Qinghe County)

机构地区：[1]清河县中心医院,河北邢台054800 [2]河北省人民医院,河北石家庄050000

出　　处：《中国急救复苏与灾害医学杂志》2020年第10期1185-1188,1191,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省2019年度医学科学研究课题计划(编号:20191401)。

摘　　要：目的 在基层医院建设完善的急诊急救医疗体系,为患者提供高效、安全的急诊服务,提高医院的总体水平.方法 完善急诊急救医疗体系建设的重要环节.在院外急救管理方面,应用PDCA的方法,通过循环改进,缩短接警后出诊时间,提高院外急救率;在急救中心及院内多科室协作方面,主要通过根本原因分析的方法,紧抓急救中心的关键指标,对出现的问题进行总结,分析根本原因,持续改进提高心肺复苏成功率,降低非预期的48 h重返重症医学科率、呼吸机相关性肺炎发生率、中心静脉导管相关性血行性感染率、重症患者死亡率.结果 在院外急救方面,实现接警后3 min内出车率>90%,院外急救率>80%;急救中心各项科室数据达到国家规定的二级医院的急救标准:心肺复苏成功率22%、非预期的48 h重返重症医学科率0.98%,呼吸机相关性肺炎发生率15.93‰,中心静脉导管相关性血行性感染率1.1‰,重症患者死亡率1.26%.结论 以精细化管理为手段,在急诊体系建设的每一个环节下功夫,提高医疗质量,能有效地优化急诊就诊流程,整合资源并有效配置,完善基层医院的急诊急救体系、为患者提供更优质的急诊服务,推动医院发展.Objective Build a perfect emergency system in primary hospitals;Provide fficient and safe emergency ser-vices for patients,and improve the overall level of hospitals.Methods To improve the important links of the construc-tion of emergency medical system.In the field of out-hospital first aid,PDCA method is used to shorten the time of vis-iting afer receiving ambulance please and improve the eficiency of out-hospital emergency;In the field of emergency center and cooperation armnong multiple departments,the key indicators of the emergeney center are grasped.Root cause analysis was used to improve the success rate of cardiopulmonary resuscitation,otherwise,the unexpected rate of return-ing to intensive care unit in 48 hours,the ineidence of ventilator-associated pneumonia,the rate of central venous cath-eter-related hematogenous infection and the mortality rate of severe patients all to be decreased.Results I.In the field of out-hospital first aid,the rate of visiting within 3 minutes after receiving ambulance please is more than 90%,and the rate of out-hospital first aid is more than 80%;2.The data of each department of the first aid center meets the first aid standard of the second level hospital stipulated by the state:the success rate of cardiopulmonary resuseitaion is 22%,the rate of returning to intensive care unit within 48 hours is 0.98%,and the rate of ventilator-associated pneumonia is 15.93%oo,The central venous catheter-related hematogenous infection rate was 1.1%o,and the mortality rate of severe patients was 1.26%.Conclusions By means of meticulous management and in every link of emergency system construetion,eforts should be made t0 improve the medical quality,efectively optimize the process of emergen-cy treatment,integrate resources and llocatle them efectively,improve the emergency first aid system of primary hospi-tals,provide better emergency services for patients,and promote the dev elopment of hospitals.

关 键 词：精细化管理 急诊急救体系 院外急救 基层医院 

分 类 号：R196.7[医药卫生—卫生事业管理]