Zhongguo cuzhong zazhi (Feb 2018)
六西格玛法在提高卒中患者CT检查时效中的应用研究 The Application Study of Six Sigma in Improving the Chronergy of CT Examination in Patients with Stroke
Abstract
目的 探讨六西格玛法优化影像检查绿色通道时效。 方法 选择2015年1-5月急诊入院疑似急性缺血性卒中患者600例为对照组，分析其各阶段时间，找 出导致患者候检时间延长的关键因素；对影响计算机断层扫描（computed tomography，CT）全程检查 时间的环节提出改进措施，并不断进行完善。将改进措施实施后再选择2016年1-5月CT检查疑似急 性缺血性卒中患者600例为实验组与改进前进行比较。运用六西格玛管理体系5步法，改善CT检查绿 色通道停留时间（CT检查阶段、CT结束-CT报告，全程目标停留时间＜30 min）。比较停留时间合格率。 结果 改进前影像科全程平均检查时间为（40±7）mi n，改进后全程平均检查时间为（28±2）mi n （P =0.001）。CT检查阶段（15±4）mi n缩短至（10±2）mi n（P =0.006），CT结束-出具报告由（25±5）min 缩短至（23±3）mi n（P =0.006）。绿色通道影像检查时间合格率提高了13.67%。 结论 六西格玛管理法在缩短急诊卒中患者影像检查绿色通道时间中效果显著，提高了抢救效率。 Abstract: Objective To investigate the time limit of six sigma approach in optimizing the chronergy of green channel for image examination. Methods A total of 600 patients with suspected acute ischemic stroke and examined by computed tomography (CT) during January-May 2015 were selected into control group, and the time of each stage was analyzed to find out the key factors to prolong the time of the patient's waiting time. The improvement measures were put forward for shortening the whole time of CT examination. After the improvement measures were implemented, another 600 patients who were diagnosed as suspected acute ischemic stroke by CT during Jan-May 2016 were selected into experimental group. Residence time in the green channel of CT examination (CT scanning, the end of CT scanning-CT report, total residence time of target<30 min) was improved by applying the 5 step method in the six sigma management system. The qualified rate of residence time was compared between two groups. Results Before improvement, the average time of the whole imaging examination was (40±7) min; after improvement, the average time of the whole imaging examination was (28±2) min (P =0.001). The duration of CT scanning was shortened from (15±4) min to (10±2) min (P =0.006); the duration of the end of CT scanning-CT report was shortened from (25±5) min to (23±3) min (P =0.006). The qualified rate of residence time in the green channel of image examination was improved by 13.67%. Conclusion The six sigma management system can significantly shorten the residence time in the green channel of image examination and effectively improve rescue efficiency in emergency patients with stroke.
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