| 摘要: |
目的
探讨利用戴明环对腹腔镜胆囊切除的临床路径进行持续改进的效果。方法 总结分析2008年3月—2010年12月北京某三级甲等医院腹腔镜胆囊切除临床路径的数据。在路径实施过程中使用戴明环的原理遵照既定的临床路径方案实施，在实施方案过程中发现路径的问题，并进行分析和总结，解决问题，修正路径后继续实施。结果 近3年共1 861例患者进行筛选，1 539例进入路径，1 408例完成路径，共131例退出路径，退出率8.5%。在戴明环原理的指导下，逐步改进流程，退出率由14.5%逐步降至1.4%。 结论 按照戴明环的原理持续改进腹腔镜胆囊切除临床路径，可以使之更加符合临床实际，促进路径发展。 |
| 关键词: 腹腔镜胆囊切除 临床路径 戴明环 诊断相关组 |
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| Continuous Improvement of Laparoscopic Cholecystectomy Clinical Pathway |
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| Abstract: |
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Objective
To explore the effect of improvement for laparoscopic cholecystectomy clinical pathway by Deming Cycle. Methods Analyzing laparoscopic cholecystectomy data from March 2008 to December 2010 in a large hospital in Beijing. In the path of the implementation process in accordance with the principles of Deming Cycle, clinical pathway program is established, and problems are found, analyzed and summarized. Results During these three years, 1 861 cases were screened. 1 539 cases got into the path and 1 408 cases completed it, 131 cases exited with 8.5% quit rate. Under the guidance of the Deming Cycle principles, the process should be gradually improved. Exit rate of 14.5% gradually approached 1.4%. Conclusions Deming Cycle continuous improvement can make clinical pathway of laparoscopic cholecystectomy meet the objective reality, and promote the path development. |
| Key words: punctuation-trim: leading">laparoscopic cholecystectomy, clinical pathway, Deming Cycle, Diagnosis Related Groups |
