质量改进模型在乳腺肿瘤患者术前超声诊断流程中的应用  

Application of model for improvement in preoperative diagnosis of breast lesions by ultrasound

作　　者：马莉 秦菁 朱庆莉[1] 刘赫[1] 张璟[1] 孝梦甦 王红燕 李建初 姜玉新[1] Ma Li;Qin Jing;Zhu Qingli;Liu He;Zhang Jing;Xiao Mengsu;Wang Hongyan;Li Jianchu;Jiang Yuxin(Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院超声医学科,100730

出　　处：《中华医学超声杂志（电子版）》2021年第4期402-406,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：中国医学科学院医学与健康科技创新工程(2017-I2M-1-006);北京市自然科学基金(7192177)。

摘　　要：目的探讨质量改进模型(MFI)在乳腺超声术前诊断流程中的应用。方法连续性选取应用MFI前的2019年1月至2019年4月在北京协和医院乳腺外科接受乳腺手术的患者50例(对照组),以及应用MFI后的2019年7月至2019年10月在北京协和医院乳腺外科接受乳腺手术的患者50例(研究组)。研究组采用MFI改善乳腺超声就诊流程,措施包括:乳腺超声专业组医师现场复核、加强乳腺亚专业组医师培训、改进预约分诊制度等;对照组未采用MFI。比较2组诊断符合率、未定性率及术前超声检查预约时间、来院检查次数的差异。结果研究组和对照组的诊断符合率分别为91.7%和70.5%,未定性率分别为4.0%和12.0%,2组比较差异均有统计学意义(P均<0.05)。研究组和对照组的术前超声检查预约时间分别为(0.58±0.98)d和(5.76±2.32)d,来院检查次数分别为(1.38±0.63)次和(2.52±0.67)次,2组比较差异均有统计学意义(P均<0.05)。结论应用MFI优化乳腺超声术前诊断工作流程,可有效利用现有医疗资源,使患者受益。Objective To explore the application of the Model for Improvement(MFI)in the procedure of preoperative diagnosis of breast ultrasound.Methods Consecutive patients with breast lesions who had a preoperative diagnosis by breast ultrasound were divided into either a study group(50 patients,from July to October 2019)or a control group(50 patients,from January to April 2019).In the study group,MFI was developed and used,which involved a series of actions such as on-site review by specialized doctors,training enhancement of specialized doctors,improvement of appointment procedures,etc.In the control group,no intervention was performed.The diagnostic accuracy rate,rate of undetermined diagnosis,appointment time,and number of hospital visits were compared between two groups.Results The diagnostic accuracy rates of the study and control groups were 91.7%and 70.5%,and the rates of undetermined diagnosis were 4.0%and 12.0%,respectively,with significantly statistical differences between the two groups(P<0.05).The appointment time of the study and control group was(0.58±0.99)days and(5.76±2.35)days,and the number of hospital visits was 1.38±0.63 and 2.52±0.67,respectively,with significantly statistical differences between the two groups(P<0.05).Conclusion MFI can optimize the procedure of preoperative diagnosis of breast ultrasound,make full use of the limited medical resources,and benefit more patients.

关 键 词：乳腺肿瘤 超声检查 质量改进模型 PDSA循环 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]