基于PDCA循环理论的门诊病历质量持续改进研究

摘要

Objective To improve the quality of outpatient medical records by using PDCA quality control tools. Methods Based on PDCA cycle theory, the quality of outpatient medical records was analyzed, the quality evaluation index system was constructed, and the inspection and evaluation mechanism was established to compare the effects before and after implementation. Results After the implementation of PDCA, the pass rate of outpatient medical records increased by 19.83％, the complaints of patients decreased by 76％, and the satisfaction of outpatients increased by 11.17％. Conclusion The PDCA cycle is effective in the quality management of outpatient medical records.%目的 运用PDCA质量控制工具提高门诊病历书写质量.方法 基于PDCA循环理论分析门诊病历质量现状,构建质量评价指标体系,建立检查考核机制,比较实施前后的效果.结果 PDCA实施之后,门诊病历合格率提高19.83％,患者投诉下降76％,门诊患者满意度提高11.17％.结论 PDCA循环在门诊病历质量管理中的效果显著.