【摘要】 目的提升基层医疗机构患者安全管理能力,推进"优质服务基层行"活动的开展,实现患者安全管理目标。方法将聚焦问题和持续质量改进(FOCUS-PDCA)管理模式运用于8家达标创建的基层医疗机构患者安全管理能力的评价与提升,通过建立持续质量控制(CQI)小组,按照寻找(Find)、组织(Organize)、澄清(Clarify)、理解(Understand)、选择(Select)、计划(Plan)、实施(Do)、检查(Check)和执行(Act)9个步骤开展持续质量改进。结果实施FOCUS-PDCA管理模式后,各基层医疗机构查对制度、手术安全核查制度、危急值报告管理、患者安全风险管理、患者参与医疗安全管理5个条目得分均高于实施前,差异均有统计学意义(P<0.05);实施FOCUS-PDCA管理模式后,自我评审、区级专家评审、市级专家评审的A、B档达标条目数均高于实施前,差异均有统计学意义(P<0.05),C级达标率为100.0%;腕带佩戴率、手术部位标识执行率、手术三方核查执行率、危急值报告符合率、安全用药咨询率等患者安全管理关键质控指标均明显改善。结论运用FOCUS-PDCA管理模式能有效提高基层医疗机构的患者安全管理能力,并可在后期的达标创建工作中推广。更多还原

【Abstract】 Objective To enhance the safety management capacity of patients in primary health care institutions,promote the "quality service at the grassroots level" activities,and to achieve the goal of patient safety management.Methods the focus on problem and continuous problem improvement(FOCUS-PDCA)management model was applied to the evaluation and improvement of patient safety management ability in 8 primary health care institutions established according to the standard.Through the establishment of CQI team,according to Organize,Find,Clarify,Understand,Select,Plan,Do,Check and Act nine steps to carry out continuous quality improvement.Results After implementing the FOCUS-PDCA management model,the scores of the checkup system,surgical safety verification system,critical value report management,patient safety risk management and patient participation in medical safety management five items in the primary health care institutions were all higher than those before implementation,and the differences were statistically significant significance(P<0.05).After implementing the FOCUS-PDCA management model,the number of A,B-level compliance items in self-review,district-level expert review and municipal-level expert review were all higher than those before implementation,and the differences were statistically significant(P<0.05),C-level compliance rate was 100.0%.The key quality control indexes of safety management,such as wristband wearing rate,surgical site marking implementation rate,operation tripartite verification implementation rate,critical value report coincidence rate and safety drug consultation rate were significantly improved.Conclusion The application of FOCUS-PDCA management model can effectively improve the patient safety management ability of primary health care institutions,and can be popularized in the later establishment of the standard.更多还原