CAJ | 학술논문

目的：探讨医院肝胆外科住院超过30天的患者的发生原因及预防对策。方法：运用FOCUS-PDCA程序分析肝胆外科住院超过30天的患者诊疗工作程序中的各个环节，找出导致住院时间延长的原因。运用成立管理小组，将住院超过30天的患者作为大查房重点，重视高龄患者术前准备，加强手术医生技术水平，加强围手术期感染管理和对患者及家属进行医疗保险知识普及等措施，使住院超过30天患者减少，科室平均住院日降低，运行效率提高。结果：实行FOCUS-PDCA程序后，住院超30天患者比率由2.15%下降到0.49%，医疗资源得到合理使用（χ2＝10.1，P<0.01）。结论：FOCUS-PDCA程序的应用可有效地减少住院超30 d患者。
목적：탐토의원간담외과주원초과30천적환자적발생원인급예방대책。방법：운용FOCUS-PDCA정서분석간담외과주원초과30천적환자진료공작정서중적각개배절，조출도치주원시간연장적원인。운용성립관리소조，장주원초과30천적환자작위대사방중점，중시고령환자술전준비，가강수술의생기술수평，가강위수술기감염관리화대환자급가속진행의료보험지식보급등조시，사주원초과30천환자감소，과실평균주원일강저，운행효솔제고。결과：실행FOCUS-PDCA정서후，주원초30천환자비솔유2.15%하강도0.49%，의료자원득도합리사용（χ2＝10.1，P<0.01）。결론：FOCUS-PDCA정서적응용가유효지감소주원초30 d환자。
Objective To Sum up the experience and lessons of unplanned reoperation so as to improve the hospital's management of Reducing the Inpatients for more than 30 days. Method We applied the FOCUS-PDCA( Plan,Do,Check,and Action)model to reduce the Inpatients for more than 30 days. The FOCUS-PDCA model was applied to investigate and analyze the causes associated with the Inpa-tients for more than 30 days,and the critical factors are improved. The method enhanced the quality of operation,reduced the occurrence of adverse events,and ensured the safety of patients. Results The incidence of the Inpatients for more than 30 days dropped from 2. 15% to 0. 49%(χ2 =10. 1,P<0. 01). Conclusion The FOCUS-PDCA process reduces the incidence of the Inpatients for more than 30 days.