基于QFD的先天性膈疝危重新生儿转运救治质量提升研究  

Quality Improvement of Critical Neonatal Transport Treatment for Congenital Diaphragmatic Hernia Based on Quality Function Deployment

作　　者：季巍[1] 杨晓倩 张艳[1] 马立霜[1] 谷庆隆[1] 王菲[1] JI Wei;YANG Xiaoqian;ZHANG Yan(Children's Hospital of Capital Institute of Pediatrics,Beijing,100020,China;不详)

机构地区：[1]首都儿科研究所附属儿童医院,北京100020

出　　处：《中国卫生质量管理》2024年第6期31-36,共6页Chinese Health Quality Management

基　　金：首都儿科研究所所级基金项目(编号:SK-2021-03)。

摘　　要：目的准确识别先天性膈疝(CDH)危重新生儿转运救治质量提升关键需求,针对性提出改进策略,提升转运救治质量。方法对某危重新生儿救治中心及新生儿转出机构的25名专家进行问卷调查和半结构访谈,以质量功能展开(QFD)为基础,借鉴SERVQUAL服务质量模型并利用亲和图(KJ)法将质量提升需求层次化,采用层次分析法确定需求重要度,创建质量屋,构建质量提升需求与质量提升措施的二维关系矩阵。结果CDH危重新生儿转运救治质量提升措施包括完善管理工作方案、建立MDT机制、麻醉医师参与转运、组建内外科转运团队、优化转运救治工作流程等。实施后,CDH危重新生儿术后死亡率降低至10.34%,临床治愈率提高至81.25%。结论运用QFD可以确定影响CDH危重新生儿转运救治质量的关键因素,提升救治质量。Objective To accurately identify the key needs to improve the quality of transport treatment for critically newborns with congenital diaphragmatic hernia(CDH),and put forward targeted improvement strategies.Methods Questionnaire survey and semi-structured interview were conducted with 25 experts from a critical newborn treatment center and neonatal transfer institution.Based on Quality Function Development(QFD),SERVQUAL service quality model was used for reference,affinity diagram(KJ)method was used to stratify quality improvement needs,and the importance of needs was determined by Analytical Hierarchy Process(AHP)to create a house of quality.The two-dimensional relationship matrix of quality improvement demand and quality improvement measures was constructed.Results The measures to improve the quality of CDH transport treatment for critically ill newborns included improving the management work plan,establishing the multi-disciplinary treatment(MDT)mechanism,anesthesiologists participating in the transport,establishing the internal and surgical transport team,and optimizing the transport treatment work flow.After implementation,the postoperative mortality of critically ill newborns with CDH was reduced to 10.34%,and the clinical cure rate was increased to 81.25%.Conclusion The application of QFD could identify the key factors affecting the quality of transport treatment of critically ill newborns with CDH,and improve the quality of treatment.

关 键 词：质量功能展开 先天性膈疝 危重新生儿 转运 多学科协作 

分 类 号：R197.323[医药卫生—卫生事业管理]