ObjectiveTo strengthen the management of medical equipment and improve the use value of medical equipment by PDCA cycle.
MethodsBetween March and June 2014, we introduced PDCA cycle into the management and use of newly-bought equipment.The use of newly-bought arteriosclerosis detector, TCD and ultrasound bone densitometer between March and June 2014 was regarded as the control group (before the implementation of PDCA cycle), and the use of these three kinds of equipment between March and June of 2015(after the implementation of PDCA cycle) was seen as the observation group.By analyzing the status quo through collected information, we drew a fishbone diagram to find out the factors that could influence the use efficiency of medical equipment.Then, corresponding measures were taken for continuous improvement, including adopting revised regulations, training technicians, quantifying work indexes, informatization, changing service mode, and examining and assessing the effect of implementation.Finally, feedback was summarized for the next PDCA cycle.
ResultsAfter the implementation of PDCA cycle, the daily check numbers of hospital medical equipment including arteriosclerosis detector, TCD, and ultrasound bone densitometer all improved significantly (P < 0.05).The daily check numbers of those three kinds of equipment after the implementation of PDCA cycle were respectively 48.52±19.72, 32.14±10.14 and 55.59±25.12, while the numbers before were respectively 32.46±20.69, 15.46±10.05 and 29.83±20.20.Moreover, working days, maximum working hours daily, and total working time were also increased after the implementation of PDCA cycle.
ConclusionThe application of PDCA cycle can effectively improve the use value of medical equipment, and improve the social benefit and economic benefit.
ObjectiveTo explore the application of PDCA cycle in the examination of medical quality of Tibetan area hospitals.
MethodsIn the October 2014, PDCA cycle theory was introduced into the examination of Tibetan hospital medical quality. We collected quality problems existing in the medical activities actively, analyzed the reason and influencing factors and made corresponding plans. Then we implemented the plans and measures strictly, surveyed the results, found out and analyzed the problems, summarized the results of the examination, and turned the unsolved problems to the next PDCA circulation. Continuous follow-up was performed until the results were satisfactory. Based on Sichuan Province Secondary Comprehensive Hospital Evaluation Standard, we analyzed the medical quality of the hospital before PDCA application (July to September 2014) and after PDCA application (October to December 2014).
ResultsThe incidence of medical nursing documents writing defects decreased from 12.4% to 5.9%. Hospital infection management defect rate declined from 13.5% to 5.3% and drug safety management defect rate declined from 11.8% to 2.5%, and all the differences were statistically significant (P<0.05).
ConclusionPDCA cycle in the Tibetan hospital for medical quality examination has greatly improved the medical quality of Tibetan hospitals.
ObjectiveTo study the effects of PDCA cycle in the control of surgical site infection (SSI).
MethodsA total of 1 761 surgeries between January 2012 and December 2013 were chosen to be monitored. PDCA cycle was used as a tool of total quality management evaluation to enhance the control of SSI.
ResultsAfter 2 to 4 cycles of PDCA, the preventive medication rate of ClassⅠ operation incision was decreased significantly (χ2=309.513，P<0.001) and the postoperative incision infection rate did not change significantly (χ2=1.474，P=0.669).
ConclusionUsing PDCA cycle can increase SSI management level and quality significantly and total quality management can be operated effectively.
Objective
To analyze the causes of drug dispensing errors and reduce the error rate through scientific precautions, and improve the quality of pharmaceutical service.
Methods
According to the PDCA cycle, existing problems were found in dispensing between January and June 2013, and the causes were analyzed. Then, from July 2013, strategies were developed to decrease the dispensing error rate. The variation trend of dispensing error rate from January 2013 to June 2017 were observed.
Result
The dispensing error rate decreased since the beginning of PDCA cycle, from 0.042‰ (the first quarter of 2013) to 0.003‰ (the second quarter of 2017).
Conclusion
The PDCA cycle is an effective intervention to detect the errors during drug delivery in inpatient pharmacy, which could improve the quality of pharmaceutical service and insure the patients’ safety.
Objective
To investigate the method and effect of continuous improvement of adverse drug reaction (ADR) monitoring in a major public hospital’s cooperating branch hospital.
Methods
PDCA cycle management was used to continuously improve the quality of ADR monitoring. ADR report network platform was established in the fourth quarter of 2014; ADR report specification training for the medical personnel was held in the first quarter of 2015; a examine mechanism was built in the second quarter of 2015. The quality and quantity of ADR monitoring before and after the PDCA cycle management were analyzed.
Results
ADR report timeliness conform to the requirements increased from 45.5% (from the first to third quarter of 2014) to 98.1% (from the fourth quarter of 2014 to the second quarter of 2015); accurate ADR types checking, normal name writting, and complete process description increased from 68.6%, 65.7%, 8.6% (from January 2014 to Frequency 2015) to 92.9%, 96.4%, 85.7% (from March to June 2015); the quantity of ADR report was obviously improved.
Conclusion
Learning from public hospital’s experience and considering its own condition in ADR monitoring, cooperating branch hospital utilizes PDCA cycle management which could continuously improve the ADR monitoring.
ObjectiveTo analyze the effectiveness of PDCA cycle model in antibiotics management by comparison of antibiotics use before and after the use of PDCA in a tertiary hospital.
MethodsProspective study was adopted to analyze the using rate of antibiotics in outpatients, emergent patients and inpatients between June 2011 and December 2013.
ResultsThe reasonable antibiotics use was improved since the beginning of PDCA cycle model. The antibiotics using rates of outpatients were 33.00%, 29.09% and 19.31%, of emergent patients were 45.00%, 32.81% and 28.94%, and of inpatients were 71.00%, 57.76% and 53.28% in year 2011 (from June to December), 2012 (from January to December) and 2013 (from January to December) respectively. Meanwhile, ClassⅠ incision antimicrobial use also decreased and bacteria examination rate continuously increased during the last three years. As a consequence, patients' cost was reduced.
ConclusionThe PDCA cycle model promotes the standardized management of clinical medication application.
Objective To explore the clinical effect of failure mode and effect analysis (FMEA) combined with PDCA cycle management model in the prevention and control of multidrug-resistant organisms (MDROs) in intensive care unit (ICU), and provide evidences for drawing up improvement measures in healthcare-associated MDRO infections in ICU. Methods In January 2020, a risk assessment team was established in the Department of Critical Care Medicine, the First People’s Hospital of Longquanyi District of Chengdu, to analyze the possible risk points of MDRO infections in ICU from then on. FMEA was used to assess risks, and the failure modes with high risk priority numbers were selected to evaluate the high-risk points of MDRO infections. The causes of the high-risk points were analyzed, and improvement measures were formulated to control the risks through PDCA cycle management model. The incidence of healthcare-associated MDRO infections in ICU, improvement of high-risk events, and satisfaction of doctors and nurses after the implementation of intervention measures (from January 2020 to June 2021) were retrospectively collected and compared with those before the implementation of intervention measures (from January 2018 to December 2019). Results Six high-risk factors were screened out, namely single measures of isolation, unqualified cleaning and disinfection of bed units, irrational use of antimicrobial agents, weak consciousness of isolation among newcomers of ICU, weak awareness of pathogen inspection, and untimely disinfection. The incidence of healthcare-associated MDRO infections was 2.71% (49/1800) before intervention and 1.71% (31/1808) after intervention, and the difference between the two periods was statistically significant (χ2=4.224, P=0.040). The pathogen submission rate was 56.67% (1020/1800) before intervention and 61.23% (1107/1808) after intervention, and the difference between the two periods was statistically significant (χ2=7.755, P=0.005). The satisfaction rate of doctors and nurses was 75.0% (30/40) before intervention and 95.0% (38/40) after intervention, and the difference between the two periods was statistically significant (χ2=6.275, P=0.012). Conclusions FMEA can effectively find out the weak points in the prevention and treatment of MDRO infections in ICU, while PDCA model can effectively formulate improvement measures for the weak points and control the risks. The combined application of the two modes provides a scientific and effective guarantee for the rational prevention and treatment of MDRO infections in ICU patients.
In the context of deepening healthcare reform and advancing the high-quality development of public hospitals, constructing a supervision system aligned with the modern hospital management system has become essential for ensuring strategic implementation and improving governance effectiveness. This paper systematically examines the three foundational pillars of such a system: the theoretical foundation grounded in scientific management principles, the historical foundation rooted in China’s governance traditions and the Communist Party’s experience in policy execution, and the practical foundation driven by the persistent challenge of “policy implementation gaps.” It further elucidates the internal logic of the supervision system as an integrated framework comprising four interrelated dimensions: core conceptual constructs, multi-dimensional value orientations, foundational coordination mechanisms, and innovative operational practices. Furthermore, the study proposes a strategic pathway centered on “renewing institutional momentum, optimizing structural design, empowering through digital technologies, and advancing systemic reforms,” thereby providing theoretical insights and practical guidance for the standardized development and refined enhancement of supervision mechanisms in modern hospitals.
ObjectiveTo study the effect of PDCA cycle model on the standardization of the application of common disinfectants, in order to promote the management level of hospital disinfection.
MethodsBy questionnaire and observation, the study was to learn the knowledge and its application in medical workers on common disinfectants. Based on the results, we tried to regulate effective preventive measures and carry out continuous improvements.
ResultAfter the implementation of PDCA cycle model, the awareness rate of the medical staff on disinfection and the application accuracy of disinfectants were significantly increased (P<0.05).
ConclusionThe implementation of PDCA cycle model can improve nosocomial infection management level effectively, ensure medical quality management and patients' safety, which is an effective way of management to reduce the rate of nosocomial infection.
ObjectiveTo discuss the application and effect of PDCA cycle in urgent values management in surgical intensive care unit.
MethodsWe analyzed the quality of 141 cases of urgent value reports in surgical intensive care unit from May to July 2013 before the application of PDCA management. The quality of urgent values were totally controlled by PDCA circle. There were 135 cases of urgent value reports after the use of PDCA cycle. The data including qualify rate of specimens, record specification rate, and handover of urgent values were compared between the two groups of urgent values.
ResultsAfter the application of PDCA cycle management, the awareness rate of urgent value content and disposal processes among medical staffs increased from 75% to 95%, with significant improvement in the quality rate of samples, recording and processing of urgent values and the quality rate of recording.
ConclusionThe application of PDCA circle management can constantly correct the problems and ensure the policy implementation in the urgent values system in clinical departments, which can promote continuous quality improvement.
