基于QFD的先天性膈疝危重新生儿转运救治质量提升研究
Quality Improvement of Critical Neonatal Transport Treatment for Congenital Diaphragmatic Hernia Based on Quality Function Deploy-ment
季巍 1杨晓倩 1张艳 1马立霜 1谷庆隆 1王菲1
作者信息
- 1. 首都儿科研究所附属儿童医院 北京 100020
- 折叠
摘要
目的 准确识别先天性膈疝(CDH)危重新生儿转运救治质量提升关键需求,针对性提出改进策略,提升转运救治质量.方法 对某危重新生儿救治中心及新生儿转出机构的 25 名专家进行问卷调查和半结构访谈,以质量功能展开(QFD)为基础,借鉴SERVQUAL服务质量模型并利用亲和图(KJ)法将质量提升需求层次化,采用层次分析法确定需求重要度,创建质量屋,构建质量提升需求与质量提升措施的二维关系矩阵.结果 CDH 危重新生儿转运救治质量提升措施包括完善管理工作方案、建立MDT机制、麻醉医师参与转运、组建内外科转运团队、优化转运救治工作流程等.实施后,CDH 危重新生儿术后死亡率降低至 10.34%,临床治愈率提高至 81.25%.结论 运用 QFD可以确定影响CDH 危重新生儿转运救治质量的关键因素,提升救治质量.
Abstract
Objective To accurately identify the key needs to improve the quality of transport treatment for critical-ly newborns with congenital diaphragmatic hernia(CDH),and put forward targeted improvement strategies.Methods Questionnaire survey and semi-structured interview were conducted with 25 experts from a critical newborn treat-ment center and neonatal transfer institution.Based on Quality Function Development(QFD),SERVQUAL service qual-ity model was used for reference,affinity diagram(KJ)method was used to stratify quality improvement needs,and the importance of needs was determined by Analytical Hierarchy Process(AHP)to create a house of quality.The two-di-mensional relationship matrix of quality improvement demand and quality improvement measures was constructed.Re-sults The measures to improve the quality of CDH transport treatment for critically ill newborns included improving the management work plan,establishing the multi-disciplinary treatment(MDT)mechanism,anesthesiologists participat-ing in the transport,establishing the internal and surgical transport team,and optimizing the transport treatment work flow.After implementation,the postoperative mortality of critically ill newborns with CDH was reduced to 10.34%,and the clinical cure rate was increased to 81.25%.Conclusion The application of QFD could identify the key factors af-fecting the quality of transport treatment of critically ill newborns with CDH,and improve the quality of treatment.
关键词
质量功能展开/先天性膈疝/危重新生儿/转运/多学科协作Key words
Quality Function Deployment(QFD)/Congenital Diaphragmatic Hernia(CDH)/Critically Ill Newborn/Transport/Multi-DisciplinaryTreatment引用本文复制引用
基金项目
首都儿科研究所所级基金项目(SK-2021-03)
出版年
2024
NETL
NSTL
万方数据