火神山医院医疗质量与安全管理实践与成效

目的对火神山医院医疗质量与安全管理的实践与成效进行分析，为COVID-19收容医院的医疗质量管理提供参考。方法收集火神山医院2020年2月4日-2020年3月22日三个阶段的治愈率、死亡率、床位使用效率、病案质量、医务人员感染率、医患告知落实率并进行统计分析。结果医院累计收治3 040名患者，出院2 290例，整体治愈率达到98.10%；死亡病例57例，死亡率为1.90%。三个阶段治愈率和死亡率没有显著区别；医院整体床位使用率为83.34%，平均床位周转次数为2.27次，平均住院日为13.63天，平均病床工作日为40天。第二阶段、第三阶段床位使用率显著高于第一阶段（X2=63.050，P=0.000）；甲级病案率为91.09%，乙级病案率为8.91%，三个阶段的病案质量不存在显著性差异（X2=3.050，P=0.218）；医嘱与医疗行为相符性抽查合格项目数为5 334，合格率为94.58%；全院医务人员感染率为0；医患沟通告知落实率为100%。结论落实医疗质量和安全管理措施对提高火神山医院的整体医疗质量起到了应有的作用，其救治质量和效率上基本达到了预期目标，整个医疗过程守住了安全底线。

Practice and Effectiveness of Medical Quality and Safety Management of Huoshenshan Hospital

ObjectiveTo analyze the effectiveness and practice of medical quality and safety management in Huoshenshan Hospital, and provide reference for medical quality management in COVID-19 admission hospital.MethodsThe cure rate, death rate, bed use efficiency, medical record quality, infection rate of medical staff, implementation rate of doctor-patient notification were collected and analyzed from February 4, 2020 to March 22, 2020.ResultsA total of 3 040 patients were admitted to the hospital, and 2 290 were discharged. The overall cure rate reached 98.10%; 57 cases died and the mortality rate was 1.90%. There was no significant difference between the cure rate and mortality rate in the three stages; the overall hospital bed utilization rate was 83.34%, the average bed turnover was 2.27 times, the average hospital stay was 13.63 days, and the average bed workday was 40 days. The bed occupancy rate in the second and third stages was significantly higher than that in the first stage (X2=63.050, P=0.000); the medical record rate of grade A was 91.09%, the rate of grade B medical records was 8.91%, and the quality of medical records in the three stages did not exist Significant difference (X2=3.050, P=0.218); the number of qualified items in the spot check of compliance between doctor's orders and medical behavior was 5 334, and the pass rate was 94.58%; the infection rate of medical staff in the hospital was 0%; the implementation rate of doctor-patient communication and notification was 100 %.Conclusion The medical quality and safety management measures have played a due role in the overall medical quality of Huoshenshan Hospital. The quality and efficiency of the treatment basically reached the expected goals, and the safety bottom line was maintained throughout the medical process.