【摘要】 目的探讨戴明环(PDCA循环)在成人胸部摄影质量管理中的应用价值。方法统计2009年1月至2011年6月应用PDCA循环前400例及2011年7月至2013年12月应用PDCA循环后400份成人胸片中肋膈角未包入片的发生率,并采用χ2检验进行比较。结果应用PDCA循环后,前、后、左、右侧与双侧肋膈角缺陷率及总缺陷率均低于应用PDCA循环前[1.5%(6/400)vs 5.3%(21/400),1.5%(6/400)vs 8.3%(33/400),0.5%(2/400)vs 2.3%(9/400),0.5%(2/400)vs 2.3%(9/400),0(0/400)vs 1.3%(5/400),4.0%(16/400)vs 19.25%(77/400)],且差异均有统计学意义(χ2=8.624,P=0.003;χ2=19.650,P<0.001;χ2=4.516,P=0.033;χ2=4.516,P=0.033;χ2=5.031,P=0.025;χ2=45.273,P<0.001)。400例成人胸片应用PDCA循环前共有77例缺陷,缺陷率为19.25%,每百万次机会缺陷率(DPMO)为192 500;应用PDCA循环后共有16例缺陷,缺陷率为4.0%,DPMO为40 000。结论运用PDCA循环,能提升胸片质量,最终达到六希格玛(6σ)质量缺陷目标即DPMO。更多还原

【Abstract】 Objective To explore the application value of Deming circle( PDCA circulation) in adult chest radiography quality management. Methods The defects of costophrenic angle outside the chest photos taken from 400 adults from January 2009 to June 2011( before PDCA circulation application) and 400 adults from July 2011 to December 2013( after PDCA circulation application) were observed and their occurrence rate were analyzed statistically and compared with chi-square test. Results The defect rates of front,back,left,right,bilateral costophrenic angle and the total defect rate after PDCA circulation application were lower than those before PDCA circulation application [1. 5%( 6 /400) vs 5. 3%( 21 /400),1. 5%( 6 /400) vs 8. 3%( 33/400),0. 5%( 2/400) vs 2. 3%( 9/400),0. 5%( 2/400) vs 2. 3%( 9/400),0( 0/400) vs 1. 3%( 5/400),4. 0%( 16/400) vs 19. 25%( 77/400) ] and the differences were statistically significant( χ2=8. 624,P = 0. 003; χ2= 19. 650,P < 0. 001; χ2= 4. 516,P = 0. 033; χ2= 4. 516,P = 0. 033; χ2= 5. 031,P = 0. 025; χ2= 45. 273,P < 0. 001). There existed 77 defects among 400 adult chest photos before PDCA circulation application,accounting for 19. 25%,defects per million opportunity( DPMO) was 192 500. There existed 16 defects among 400 adult chest photos after PDCA circulation application,accounting for 4. 0%,DPMO was 40 000. Conclusion PDCA circulation can improve the quality of chest radiography,and reach the DPMO quality defect target set by 6σ ultimately.更多还原