某三级甲等综合医院非计划重返手术室再手术分析  

Analysis of the Reasons for Unplanned Return to the Operating Room for Reoperation in a Certain Tertiary Grade A Comprehensive Hospital and Management Suggestions

作　　者：胡娟[1] 余文珠[1] 王晓燕[1] 耿方娅 贺雅静 沈威[1] 杨维兰[1] HU Juan;YU Wenzhu;WANG Xiaoyan;GENG Fangya;HE Yajing;SHEN Wei;Yang Weilan(Medical Department,The Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330000)

机构地区：[1]南昌大学第二附属医院医务处,江西南昌330000

出　　处：《江苏卫生事业管理》2022年第11期1467-1470,1486,共5页Jiangsu Health System Management

摘　　要：目的:对非计划重返手术室再手术的关键特性进行分析,探索通过行政化自上而下管理模式,多部门协同管理,以有效降低非计划重返手术室再手术发生率,提高医疗质量和围手术期管理水平。方法:对某三级甲等综合医院2018年-2020年非计划重返手术室再手术发生率、科室分布、手术级别、发生原因等进行回顾性研究,针对管理薄弱环节,自2021年实施行政化自上而下MDT管理模式干预,运用PDCA工具持续改进分析相关干预效果。结果:2021年非计划重返手术室再手术发生率0.26%,低于2018年-2020年的0.32%;由非计划重返手术室再手术导致的医疗纠纷及相关质量指标明显好转。结论:通过行政化自上而下MDT管理手段,可有效降低非计划重返手术室再手术发生率,减轻患者经济负担,改善就医体验,提高患者满意度。Objective:To analyze the key characteristics of the index of unplanned return to the operating room for reoperation,and to explore how to effectively reduce the unplanned return to the operating room for reoperation through an administrative top-down man⁃agement model,multi-department collaborative management.In order to effectively reduce the incidence of unplanned return to the op⁃erating room for reoperation,improve the quality of medical care and the level of perioperative management.Methods:A certaintertiary grade A general hospital was taken as the research object,and a retrospective study was conducted on the incidence of unplanned re⁃turn to the operating room for reoperation,the distribution of departments,the level of surgery,and the causes of occurrence from 2018 to 2020.It was found that the management was weak.The administrative top-down MDT management mode intervention was added from 2021,and use PDCA tools to continuously improve and analyze related intervention effects.Results:The incidence of unplanned return to the operating room for reoperation in 2021 was 0.26%,lower from 0.32%in 2018-2020.Medical disputes and related quality indicators caused by unplanned return to the operating room for reoperation were significantly improved.Conclusion:The administra⁃tive top-down MDT management method can effectively reduce the incidence of unplanned return to the operating room for reopera⁃tion,reduce the economic burden of patients,improve medical experience,and improve patient satisfaction.

关 键 词：非计划重返手术室再手术率 行政化管理 医疗质量 

分 类 号：R197.39[医药卫生—卫生事业管理]