基于失效模式与效应分析联合流程分析法的预住院流程再造  

Pre-hospitalization process reengineering based on the failure mode and effect analysis combined with process analysis method

作　　者：徐建平[1] 胡小云 徐立红 章敏[2] 顾水琴 钱兴华[3] 李晓赟 Xu Jianping;Hu Xiaoyun;Xu Lihong;Zhang Min;Gu Shuiqin;Qian Xinghua;Li Xiaoyun(Admission Preparation Center,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China;Nursing Department,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China;Outpatient Office,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China;Medical Department,Jiaxing Maternal and Child Health Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市妇幼保健院入院准备中心,嘉兴314000 [2]嘉兴市妇幼保健院护理部,嘉兴314000 [3]嘉兴市妇幼保健院门诊办公室,嘉兴314000 [4]嘉兴市妇幼保健院医务科,嘉兴314000

出　　处：《中华医院管理杂志》2023年第5期387-391,共5页Chinese Journal of Hospital Administration

基　　金：浙江省教育厅一般科研项目(Y202045315);嘉兴市科技局公益类项目(2021AD30064)。

摘　　要：预住院服务是医疗机构贯彻国家深化医疗保障制度改革的重要举措。2018年,浙江省提出"最多跑一次改革",要求建立入院准备中心开展预住院服务。2021年6月,某妇幼保健院联合应用失效模式与效应分析和流程分析法,筛选住院流程高风险点,梳理各环节的作业价值和作业功能,评估改进环节,对入院准备中心预住院流程进行再造。通过上线独立的信息系统,设立一键自动导入院前医嘱功能,撤除各专科现场开医嘱医师等改进措施,重点优化了开具院前医嘱、预住院办理等候和预住院办理等预住院环节。预住院中心的院前医嘱完整率、院前平均等待天数和患者满意度得分分别从流程再造前的91%、2.99d和93.46优化到再造后的92%、2.44d和95.80分,实现了预住院服务质量和效率的双提升,为我国医疗机构开展安全高效的预住院服务提供参考。The pre-hospitalization service is an important initiative for medical institutions to implement the national reform of the medical security system.In 2018,Zhejiang province proposed the"most run once reform",requiring the establishment of an admission preparation center to carry out pre-hospitalization services.In June 2021,a certain maternal and child health hospital conducted a process reengineering for the pre admission process of the admission preparation center by applying the combined process analysis and failure mode and effects analysis,high-risk points of the hospitalization process were screened,the job value and job functions of each sector were sorted out,and the sector for improvement sector was evaluated,to launch an independent information system,establish a one click automatic import of pre hospital medical orders function,and remove on-site billing physicians from various specialties for improvement measures.The steps of the process had been optimized,inlcuding issuing pre hospital medical orders,waiting for pre-hospitalization,pre-hospitalization,and so on.The completeness rate of pre hospital medical orders,average waiting days before hospitalization,and patient satisfaction scores of pre hospitalization centers had changed from 91%,2.99 days,and 93.46 points before process reengineering to 92%,2.44 days,and 95.80 points after reengineering,respectively.This practice had achieved dual improvements in pre admission service quality and efficiency,so as to provide a reference for China′s medical institutions to carry out safe and efficient pre admission services.

关 键 词：预住院流程 流程再造 失效模式与效应分析 流程分析法 患者满意度 

分 类 号：R197.5[医药卫生—卫生事业管理]