中国当代儿科杂志2025，Vol.27Issue(2)：148-154,7.DOI:10.7499/j.issn.1008-8830.2410046
提高早产儿出院后随访率的质量改进研究
A quality improvement study on improving the follow-up rate of preterm infants after discharge
摘要
Abstract
Objective To explore the measures to improve the follow-up rate of preterm infants after discharge,and to evaluate the effectiveness of these measures using quality improvement methodology.Methods The follow-up status of preterm infants discharged from March to May 2017 was used as the baseline before quality improvement,and a specific quality improvement goal for the follow-up rate was proposed.The Pareto chart was used to analyze the causes of follow-up failure,and a key driver diagram was constructed based on the links involved in improving follow-up rate.The causes of failure were analyzed to determine the key links and intervention measures for quality improvement,and the follow-up rate was monitored weekly using a control chart until the quality improvement goal was achieved.Results The follow-up rate of preterm infants after discharge was 57.92%(117/202)at baseline before quality improvement,and the quality improvement goal was set to increase the follow-up rate of preterm infants from baseline to more than 80%within 12 months.The Pareto chart analysis showed that the main causes of follow-up failure were deficiencies in follow-up file management and irregular follow-up times(33.70%,31/92),insufficient follow-up education and poor communication(25.00%,23/92),and the inability to meet the diverse needs of parents(18.48%,17/92).Based on the key links for quality improvement and the main causes of follow-up failure,the following intervention measures were adopted:(1)strengthen follow-up publicity and education;(2)build a follow-up team;and(3)establish a follow-up platform and system.The control chart indicated that with the implementation of the above intervention measures,the weekly follow-up rate increased to 74.09%(306/413)in July 2017 and 83.09%(511/615)in December 2017,finally achieving the quality improvement goal.During the COVID-19 pandemic,the follow-up rate of preterm infants fluctuated between 23.54%(460/1 954)and 70.97%(1 931/2 721),and subsequently,it returned to pre-pandemic levels starting in February 2023.Conclusions The application of quality improvement methodology can help to formulate intervention measures based on the main causes of follow-up failure,thereby improving the follow-up rate of preterm infants after discharge.This quality improvement method is feasible and practical and thus holds promise for clinical application.关键词
随访率/出院/质量改进/早产儿Key words
Follow-up rate/Discharge/Quality improvement/Preterm infant引用本文复制引用
常贺生,杨雪,鞠俊,徐雯雅,吴迪,万小满,李正红..提高早产儿出院后随访率的质量改进研究[J].中国当代儿科杂志,2025,27(2):148-154,7.基金项目
中央高水平医院临床科研专项(2022-PUMCH-B-077). （2022-PUMCH-B-077）
