中国卒中杂志2024，Vol.19Issue(8)：873-879,7.DOI:10.3969/j.issn.1673-5765.2024.08.003
基于DMAIC模型的妊娠合并脑血管病急诊就诊流程优化研究
Research on Optimization of the Emergency Treatment Process for Pregnancy Complicated by Cerebrovascular Diseases Based on the DMAIC Model
摘要
Abstract
Objective To optimize the medical treatment process of pregnant women with cerebrovascular diseases using the define,measure,analyze,improve,control(DMAIC)model in the lean six sigma(LSS)management,improve the efficiency of medical treatment,and ensure the safety of both mothers and infants. Methods In December 2021,Beijing Tiantan Hospital,Capital Medical University optimized the medical treatment process for critically ill pregnant women according to the DMAIC model with the measures listed below:sorting out the medical treatment process,identifying the key nodes of hospital delays,such as hospital arrival to medical order issuance,blood sampling to testing,and medical order issuance to imaging examination,tracking and analying the processes of the above nodes,finding out the reasons for the delay,and taking improvement measures to optimize the process.This study retrospectively included pregnant women with cerebrovascular diseases before process optimization(from January 2019 to December 2021)as the pre-optimization group,and patients after process optimization(from January 2022 to December 2023)as the post-optimization group.The time of hospital arrival to medical order issuance,blood sampling to testing,medical order issuance to imaging examination,and hospital arrival to hospitalization was compared between the two groups. Results After the optimization of the medical treatment process,the overall efficiency of emergency treatment for pregnant women with cerebrovascular diseases was improved.After optimization,the time of hospital arrival to medical order issuance[24.0(13.5-38.5)min vs.39.0(17.5-98.0)min,P=0.027],medical order issuance to imaging examination[48.0(10.0-73.0)min vs.65.5(22.7-90.7)min,P=0.025],and hospital arrival to hospitalization[120.0(93.0-149.0)min vs.218.0(123.0-382.7)min,P＜0.001]as all reduced compared with that before optimization,and the difference was statistically significant.The time of blood sampling to testing showed a trend of shortening,but there was no statistically significant difference before and after optimization. Conclusions Using the DMAIC model can identify the key links and points of process optimization and has substantial effects on optimizing the emergency treatment process for pregnant patients with cerebrovascular diseases.关键词
精益六西格玛管理/妊娠/脑血管病/急诊/流程优化Key words
Lean six sigma/Pregnancy/Cerebrovascular disease/Emergency/Process optimization分类
医药卫生引用本文复制引用
梁艳超,王晓岩,单凯..基于DMAIC模型的妊娠合并脑血管病急诊就诊流程优化研究[J].中国卒中杂志,2024,19(8):873-879,7.基金项目
北京市卫生健康委员会高层次公共卫生技术人才建设项目(学科骨干-03-01) （学科骨干-03-01）
