中国全科医学 ›› 2023, Vol. 26 ›› Issue (15): 1811-1816.DOI: 10.12114/j.issn.1007-9572.2022.0821

• 住院血糖监测专题研究 • 上一篇    下一篇

基于PDCA循环构建住院患者血糖主动干预运营管理模式的实践研究

周益1, 高芸艺1, 李舍予2, 童南伟1, 陈敏1, 李大江1, 蒋艳1, 张伟义1, 陈相军1,*()   

  1. 1.610041 四川省成都市,四川大学华西医院
    2.610041 四川省成都市,四川大学华西医院中国循证医学中心Cochrane中国中心MAGIC中国中心
  • 收稿日期:2022-09-12 修回日期:2022-12-21 出版日期:2023-05-20 发布日期:2022-12-30
  • 通讯作者: 陈相军

  • 作者贡献:周益负责研究设计、资料收集和论文撰写;童南伟、陈敏、李大江、蒋艳、张伟义负责总体研究思路设计和质量控制;高芸艺负责数据收集和绘制图表;李舍予负责研究设计和文章审校;陈相军负责质量控制、文章修订,并对文章整体负责。
  • 基金资助:
    四川省科技厅科研课题--住院糖尿病患者循证智慧血糖管理系统的研发(2022YFH0114)

Performance Surveillance of Active Blood Glucose Management during Hospitalization Based on the PDCA Cycle: a Practical Study

ZHOU Yi1, GAO Yunyi1, LI Sheyu2, TONG Nanwei1, CHEN Min1, LI Dajiang1, JIANG Yan1, ZHANG Weiyi1, CHEN Xiangjun1,*()   

  1. 1. West China Hospital, Sichuan University, Chengdu 610041, China
    2. Chinese Evidence-based Medicine Center/Cochrane China Center/MAGIC China Center, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2022-09-12 Revised:2022-12-21 Published:2023-05-20 Online:2022-12-30
  • Contact: CHEN Xiangjun

摘要: 住院患者血糖控制的临床需求增加催生临床新技术与医疗模式转变,为医疗管理带来了挑战。本文利用PDCA(Plan-Do-Check-Action)循环构建住院患者血糖主动干预运营管理模式。从"人""机""料""法""环"5个维度抽象化实际管理问题,运用PDCA循环质量管理工具,通过"计划-执行-检查-处理"循环,推进运营管理模式构建,最终建立多部门联动机制,形成分级管理制度、流程和血糖管理信息化系统,建立质量控制体系和绩效运营保障体系。利用PDCA循环构建住院患者血糖主动干预运营管理模式在四川大学华西医院推广顺利,并取得一定成效,血糖管理后患者72 h血糖达标率逐月上升。因此,本院基于PDCA循环构建住院患者血糖主动干预运营管理模式可为其他医疗机构开展血糖管理工作提供借鉴参考,对提高住院患者血糖管理水平有重要意义。

关键词: 血糖管理, 住院病人, 主动干预, 运营管理, PDCA循环, 临床医疗模式

Abstract:

The increased clinical demand for glycemic control in hospitalized patients has led to a new transformation of clinical technologies and medical models, which has brought challenges to medical management. We built an active blood glucose intervention operation and management model for inpatients using the Plan-Do-Check-Action (PDCA) cycle: Firstly, we concertized the practical management problems through root cause analysis, namely man - machine - material - method - environment. Then, we used PDCA cycle quality management tools to facilitate the construction of the operation and management models based on the PDCA cycle. We finally formed an efficient multidepartment cooperation mechanism and tiered management system and process for inpatients, and established an information system of glycemic management, quality control system and operational performance guarantee system. By use of the model, the blood glucose management has been successfully promoted with some achievements obtained, and the rate of blood glucose meeting the target level within 72 hours after glycemic management has increased month by month in West China Hospital, Sichuan University. This model developed by our hospital may be used as a reference for other hospitals to conduct glycemic management, and it also has great significance for improving the inpatient blood glucose management.

Key words: Blood glucose management, Inpatients, Active intervention, Operational management model, PDCA cycle, Clinical practice patterns