摘要
目的:构建医疗设备双闭环管理模式,探讨其在血液透析机保养及故障管控中的应用价值.方法:基于医疗设备临床运行闭环管理和技术保障闭环管理,构建医疗设备双闭环管理模式.选取2021年1月至2023年1月复旦大学附属华山医院临床在用的65台血液透析机,分别采用常规设备管理方法(简称常规模式)管理和双闭环管理模式(简称双闭环模式)管理.对比两种管理模式血液透析机的成本效益、社会效益、故障发生情况、管理质量有效事项、消毒情况、患者平均等候时间和患者满意度.结果:双闭环模式的血液透析机运行利润增长率、诊疗费用增长率、使用年限指数(I年限)百分比、科研服务增长率、诊疗服务增长率、开机率和运转率分别为(3.95±1.04)%、(3.80±0.58)%、(1.58±0.31)%、(4.30±0.95)%、(7.91±1.58)%、(96.58±2.76)%和(89.90±5.58)%,均高于常规模式,其差异有统计学意义(t=5.418、10.070、7.490、17.570、11.820、8.849、6.840,P＜0.05);技术保障费用支出增长率、细菌菌落数、细菌内毒素含量和患者平均等待时间分别为(2.60±0.33)%、(0.370±0.008)cfu/ml、(0.0063±0.0011)EU/ml和(0.76±0.13)h,均少于常规模式,其差异有统计学意义(t=23.040、82.985、14.482、19.530,P＜0.05).双闭环模式的血液透析机故障发生为6台(占9.23%),低于常规模式,其差异有统计学意义(x2=6.392,P＜0.05);采集的120项管理数据中质量控制检测、维护维修、临床操作、信息数据和报废处理的有效数据分别为115项(占95.83%)、107项(占89.17%)、116项(占96.67%)、114项(占95.00%)和117项(占97.50%),管理数据有效率均高于常规模式,其差异有统计学意义(x2=15.238、16.596、9.808、15.585、16.119,P＜0.05).结论:双闭环管理模式应用于血液透析机保养及故障管控,能够有效提升设备成本效益、社会效益、管理质量及患者满意度,降低故障发生率.
Abstract
Objective:To construct a double-closed-loop management model for medical equipment and explore its application value in hemodialysis machine maintenance and fault management.Methods:Based on the closed-loop management of clinical operation of medical equipment and the closed-loop management of technical support,a dual closed-loop management model of equipment was constructed.65 hemodialysis machines in clinical use in Huashan Hospital Fudan University from January 2021 to January 2023 were selected and divided into a conventional mode and double-closed-loop mode according to different management modes.The conventional mode adopted conventional equipment management methods,and the double-closed-loop mode adopted a double-closed-loop management model.The cost-effectiveness,social benefit,failure occurrence,effective management quality matters,disinfection status,average patient waiting time and satisfaction were compared between the two groups.Results:The hemodialysis machine operating profit growth rate,diagnosis and treatment cost growth rate,service life index,scientific research service growth rate,diagnosis and treatment service growth rate,startup rate and operation rate of the double-closed-loop mode were(3.95±1.04)%,(3.80±0.58)%,(1.58±0.31)%,(4.30±0.95)%,(7.91±1.58)%,(96.58±2.76)%and(89.90±5.58)%,which were higher than those of the Conventional mode,the difference was statistically significant(t=5.418,10.070,7.490,17.570,11.820,8.849,6.840,P<0.05).The technical support expenses growth rate,bacterial colony count,bacterial endotoxin content and average patient waiting time of patients in the Double-closed-loop mode were(2.60±0.33)%,(0.370±0.008)cfu/ml,(0.0063±0.0011)EU/ml and(0.76±0.13)h,which were less than those of the conventional mode,the difference was statistically significant(t=23.040,82.985,14.482,19.530,P<0.05).The incidence rate of hemodialysis machine failure in the double-closed-loop mode was 9.23%(6/65),which was lower than that in the conventional mode,the difference was statistically significant(x2=6.392,P<0.05);among the 120 items of management data collected,quality control testing,maintenance and repair,clinical operation,information data,and scrap processing effectiveness rates were 95.83%(115/120),89.17%(107/120),96.67%(116/120),95.00%(114/120),and 97.50%(117/120),respectively,which were higher than those of the conventional mode,the difference was statistically significant(x2=15.238,16.596,9.808,15.585,16.119,P<0.05).Conclusion:The application of closed-loop management model to hemodialysis machine maintenance and fault management can effectively improve equipment cost-effectiveness,social benefits,management quality and patient satisfaction,and reduce the incidence of faults.
国家科技期刊平台
NSTL
维普
万方数据