Effect Analysis of Continuous Quality Improvement in Ischemic Stroke Care

doi:10.3969/j.issn.1673-5765.2016.09.007

Abstract

Abstract:

Objective To evaluate the changes of medicare quality before and after the continuous quality improvement (CQI) intervention in ischemic stroke care. Methods A total of 261 inpatients who was diagnosed with cerebral ischemic stroke (CIS) at neurology department of Shanxi Cardiovascular Hospital during October, 2013 to March, 2014 were enrolled as the baseline group, and 218 patients with CIS who were treated after the implementation of CQI between April, 2014 and November, 2014 were enrolled as intervention group. The 12 key performance indexes (KPIs) and one comprehensive performance indicator of two groups were compared. Results The comprehensive performance index of experimental group had an significant improvement compared to the control group (92.53% vs 81.52%, P <0.001). Different degrees of improvement in 12 individual KPIs have been observed in experimental group after the CQI intervention had been applied. Among the 12 individual KPIs, dysphagia screening (99.54% vs 96.55%, P =0.03), rehabilitation intervention (88.07% vs 68.22%, P <0.001), statin treatment (98.62% vs 77.01%, P <0.001), anticoagulation for patients with atrial fibrillation (66.67% vs 20.00%, P =0.02) had obvious improvement with statistical significance. Conclusion The standardized continuous quality improvement intervention is capable of improving the quality of ischemic stroke care, which is deserved of further popularization and application.

Key words: Ischemic stroke; Medical care; Continuous quality improvement; Key performance index

摘要：

目的评价缺血性卒中医疗质量持续改进项目（continued quality improvement，CQI）前后缺血性卒中医疗质量的变化。方法收集山西省心血管医院神经内科进行缺血性卒中医疗质量持续改进前（2013年10月-2014年3 月）住院治疗的缺血性卒中患者261例作为基线组，实施质量改进方案后（2014年4月-2014年11月）收治的缺血性卒中患者218例作为干预组，比较两组12项医疗质量关键绩效指标（key performance index， KPI）以及综合医疗质量指标的变化。结果实施医疗质量持续改进后干预组综合医疗质量指标为92.53%，高于基线组（81.52%) (P <0.001）。干预组各项KPI指标较基线组均有不同程度的提高，其中吞咽困难筛查（99.54% vs 96.55%，P =0.03）、康复干预（88.07% vs 68.22%，P <0.001）、他汀药物使用（98.62% vs 77.01%， P <0.001）、心房颤动患者抗凝治疗（66.67% vs 20.00%，P =0.02）执行率有明显的升高。结论实施标准缺血性卒中医疗质量持续改进方案有助于改善卒中医疗服务质量，值得进一步推广应用。

关键词: 缺血性卒中; 医疗质量; 持续改进; 关键绩效指标

ZHANG Xuan,CHENG Tao, ZHANG Wei-Yan, et al.. Effect Analysis of Continuous Quality Improvement in Ischemic Stroke Care[J]. Chinese Journal of Stroke, 2016, 11(09): 747-751.

张萱，成涛，张为艳，王春娟，李子孝，王伊龙，陈小飞. 缺血性卒中医疗质量持续改进项目实施效果分析[J]. 中国卒中杂志, 2016, 11(09): 747-751.

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