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目的分析毛细支气管炎临床路径病例的变异原因,提出相应对策,为临床路径变异的干预提供依据及支持。方法将2014年10月至2016年4月进入毛细支气管炎临床路径管理的75例病例作为研究对象,统计分析其变异原因和类型。结果毛细支气管炎临床路径主要变异因素为患方因素,占总变异数的86.21%,医护人员相关变异因素占总变异数的12.07%,医院系统相关的变异总变异数的1.72%;负性变异占比80%,明显多于正性变异20%的占比;不可控因素的变异占比为81.03%,可控因素的变异占比为18.97%。结论临床路径实施过程中多种因素影响产生变异,通过对正负性变异及可控性的分析和总结,进行有针对性地改进措施,以达到完善和改进临床路径管理的目的,从而实现规范医疗行为、提高医疗质量、控制医疗成本和提高服务满意度。
Objective To analyze the causes of variation of clinical pathological cases of bronchiolitis and to put forward corresponding countermeasures to provide the basis and support for the intervention of clinical pathological variations. Methods From October 2014 to April 2016, 75 patients who entered the clinical management of bronchiolitis were enrolled in this study. The causes and types of variation were statistically analyzed. Results The main pathological variables were pathological factors, accounting for 86.21% of the total variance, 12.07% of the total variance and 1.72% of the total variance of the hospital system; negative variations accounted for The proportion of uncontrollable factors accounted for 81.03%, while that of controllable factors accounted for 18.97%. Conclusion There are many factors influencing the clinical pathway during the course of the clinical pathway. Through the analysis and summary of the positive and negative variation and controllability, targeted improvement measures are taken to achieve the purpose of improving and improving the clinical pathway management so as to achieve the standardization Medical behaviors, improving medical quality, controlling medical costs and improving service satisfaction.