Evaluation of the Effect of PDCA in Hospital Health Management

Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room

To explore the application effect of plan, do, check, action (PDCA) cycle on nursing quality management and risk control in digestive endoscope room. Ninety patients who received digestive endoscopy care before undergoing PDCA circulation mode risk control from January 2022 to April 2022 were selected as the Common group. From May 2022 to December 2022, 156 patients who underwent digestive endoscopy care after undergoing PDCA cycle mode risk control were selected as the PDCA group. Compare the infection status of patients in the endoscope room and the qualification of the air in the endoscope room before and after PDCA circulation management. Compare the respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, and nursing satisfaction of patients in the Common group and the PDCA group. Compare the qualified rate of endoscopic cavity disinfection before and after PDCA cycle management, the qualified rate of endoscopic external disinfection, and the management score. Four patients in the Common group developed infection, with an infection rate of 4.44%. One case of infection occurred in the PDCA group, with an infection rate of 0.64%. The qualified rate of the endoscope room air in the Common group was 92.22%, while the qualified rate of the endoscope room air in the PDCA group was 98.72%. Compared with the Common group, the infection rate of patients in the PDCA group significantly decreased, and the qualified rate of air in the endoscope room significantly increased. The respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, nursing errors, and nursing complaint rates of patients in the PDCA group were significantly lower than those in the Common group, and nursing satisfaction was significantly higher than those in the Common group. The qualified rate of endoscopic cavity disinfection and endoscopic external disinfection in the PDCA group were significantly higher than those in the Common group. Compared with before management, the scores of post management, nursing safety, disinfection and isolation, instruments, theoretical tests, and operational tests of nursing personnel after management increased significantly. The PDCA cycle is well applied in nursing quality management and risk control in the digestive endoscope room.

What Makes a Hospital Excellent? A Qualitative Study on the Organization and Management of Five Leading Public Hospitals in China

Purpose

To summarize the organizational and management experiences and explore the organizational theoretical model of five leading public hospitals in China.

Patients and Methods

Purposive sampling was used to select five leading hospitals in different regions of China under the National Health Commission and Provincial Health Commission as study hospitals for the study. From August 2021 to March 2022, 8 leaders and 39 managers from these hospitals were surveyed using semi-structured interviews. The data and information were analyzed in four dimensions using thematic analysis and grounded theory, focused on summarizing the experiences and practices of China's leading hospitals in organizational system, culture, operations and performance management, and employee development. This study complied with the COREQ guidelines for reporting qualitative research.

Results

An organizational system model of the characteristics of hospital excellence was developed using four core attributes: organizational system, organizational culture, operations and performance management, and employee development; the model was named the System-Culture-Operation-Performance-Employee (SCOPE) model. Organization and management among leaders and managers in China's leading hospitals are based on the SCOPE process, resulting in employees' well-being, patients' positive outcomes, and organizational excellence. In terms of hospital culture, while adhering to the Hippocratic Oath, the hospital is deeply influenced by traditional Chinese culture, which emphasizes "benevolence" and "love", leading all staff to adhere to "patient-centered care and service." In terms of operations management, a separate operations management department is responsible for hospital operations and performance assessment. As for employee development, the staff's sense of reverence for their profession is emphasized and a reasonable salary system and good practice environment are established to promote staff motivation.

Conclusion

The SCOPE model reveals the perspectives of leaders and managers in China's leading hospitals regarding organization and management under a Chinese cultural background. These findings can complement the existing literature on hospital management systems.

Impact of Pharmacist-Led PDCA Cycle in Reducing Prescription Abandonment: An Action Research from China

Purpose

Taking medicine as prescribed in time plays an important role in the treatment of diseases. However, some prescriptions have not picked up in time for various reasons. To analyze the influencing factors in patients with prescription abandonment and the role of pharmacists in Plan-Do--Check-Act (PDCA) cycle, we conducted a study in our hospital of Hangzhou, China.

Methods

Based on the prescription abandonment from October 1, 2021 to March 31 2022, we collected and analyzed the possible causes. According to the PDCA management method, we conducted improvement measures and supervised the implementation of measures from April 1, 2022 to September 30, 2022. The number, the proportion and the amount of prescription abandonment before and after establishment of the PDCA cycle were analyzed.

Results

Three measures were proposed and applied to improve the prescription abandonment:(I) Enhancing the education and training to the staff. (II) Improving the medical environment for patients, especially the environment for taking medicine. (III) Updating the computer information software. After the implementation of PDCA, the number of prescription abandonment decreased from 2030 to 775, there was significant reduction in the proportion of prescription abandonment (4.75‰ vs 1.77‰, P<0.05), and the amount of prescription abandonment decreased from $36,161.11 to $17,041.59. The target compliance rate was 108.36%.

Conclusion

The implementation of pharmacist-led PDCA can effectively reduce the number, the proportion and the amount of prescription abandonment, Moreover, Pharmacists play an important role in improving the management quality of outpatient pharmacy, and PDCA is a feasible and effective management tool for reducing prescription abandonment.

Study on thermal health and its safety management mode for the working environment

Thermal health concerns have gained significant attention due to the heightened health risks faced by workers who are exposed to extreme thermal environments for prolonged periods. To ensure the occupational health and safety of such workers, and to enhance work efficiency, it is imperative to examine the characteristics of thermal health in the working environment. This study proposes three key elements of thermal health in the working environment, namely thermal health states, absence of heat-related illnesses, and heat adaptability, which can be used to develop a safety management framework for thermal health. By exploring the interconnections between these elements, the study summarizes their features and outlines the necessary precautions to safeguard them. The PDCA (plan/do/check/action) cycle management mode is utilized as a framework, with the three components of thermal health forming the core, to establish a safety management mode for thermal health. To ensure that employees work in a safe, healthy, comfortable, and productive environment, the assessment and control objectives of the thermal environment are regularly revised through the use of labor protection technology and thermal environment control technology. This paper presents a PDCA cycle safety management mode based on the characteristics of thermal health, which offers novel insights and approaches for assessing and managing workers' thermal health.

Retracted: Evaluation of the Effect of PDCA in Hospital Health Management

[This retracts the article DOI: 10.1155/2021/6778045.].

Application of the PDCA cycle for implementing the WHO Safe Childbirth Checklist in women with vaginal deliveries

The World Health Organization Safe Childbirth Checklist (SCC) has been recommended globally. However, the results are inconsistent. The aim of this study was to investigate the effectiveness of implementing the SCC based on plan-do-check-act (PDCA) cycle management. From November 2019 to October 2020, women who were hospitalized and had vaginal deliveries were enrolled in this study. Before October 2020, the PDCA cycle was not applied for the SCC, and women who had vaginal deliveries were included in the pre-intervention group. From January 2021 to December 2021, the PDCA cycle was applied for the SCC, and women who had vaginal deliveries were included in the post-intervention group. The SCC utilization rate and the incidence of maternal and neonatal complications were compared between the 2 groups. The SCC utilization rate in the post-intervention group was higher than that in the pre-intervention group (P < .01). The postpartum infection rate in the post-intervention group was lower than that in the pre-intervention group, and the difference was statistically significant (P < .05). After the intervention, postpartum hemorrhage, neonatal mortality, and neonatal asphyxia rates were also reduced, although no significant differences were observed between the 2 groups. There was no significant difference in the third-degree perineal laceration or neonatal intensive care unit hospitalization rate between the 2 groups (P > .05). Application of the PDCA cycle can improve the SCC utilization rate, and the SCC combined with the PDCA cycle can effectively reduce the postpartum infection rate.

PDCA nursing in improving quality management efficacy in endoscopic submucosal dissection

BACKGROUND

Endoscopic submucosal dissection (ESD) is a common surgical strategy for the treatment of early gastrointestinal tumors and precancerous lesions. PDCA nursing can effectively prevent potential risks in the nursing process, protect patient privacy, and improve patient satisfaction, nursing integrity, and service quality.

AIM

To explore the effects of PDCA nursing model on the quality management of gastrointestinal ESD, the 36-item Shot-Form Health Survey (SF-36) score, and negative emotions.

METHODS

A total of 178 patients who underwent ESD between January 2020 and January 2021 were divided into two groups. The usual care mode was the control group, with 80 cases from January to July 2020; from July 2020 to January 2021, 98 patients were enrolled in the PDCA care mode as the research group. The length of hospital stay and the costs of the two groups were statistically analyzed. The visual analog scale (VAS), SF-36 score, Zung self-rating scale for anxiety and depression, and postoperative complications were also assessed.

RESULTS

The length of hospitalization and cost in the research group were lower than in the control group (P < 0.05), and the VAS scores were lower than those before care (P < 0.05). Moreover, the VAS score of the research group was lower than that of the control group (P < 0.05). The SF-36 scores for physical function, role status, social function, pain, mental health, and physical strength were higher in the research group than in the control group (P < 0.05). Depression and anxiety scores of the research group were lower than those of the control group (P < 0.05). The postoperative complication rate in the research group (6.12%) was lower than in the control group (32.50%) (P < 0.05).

CONCLUSION

PDCA nursing can improve the quality of management of ESD surgery, shorten the length of hospital stay and cost, reduce the VAS and Zung scale scores to alleviate adverse emotions, improve the SF-36 score, and reduce postoperative complications.

The Influence of PDCA Cycle Management Mode on the Enthusiasm, Efficiency, and Teamwork Ability of Nurses

Background

The PDCA cycle consists of four stages: P (plan), D (design), C (check), and A (action). With the wide acceptance of PDCA cycle, there is an urgent need to verify the effect of combining this concept with clinical nursing work. Therefore, on the basis of in-depth study of a large number of related literature, the influence of PDCA cycle management mode on nurses' work efficiency, work enthusiasm, and teamwork ability was explored, so as to provide reference experience for exploring the nursing quality management model adapted to the development of medicine.

Objective

To explore the application of PDCA circulation management mode in clinical nursing work and to explore its influence on the work efficiency, enthusiasm, and team cooperation ability of nurses.

Methods

From January 2019 to January 2021, the patients were divided into two groups. The control group received routine nursing care, and the research group received the PDCA circulation management mode. Both groups of nurses received one-year training. The nursing quality, the ability of teamwork, the scores of personal quality control in clinical departments, the scores of nursing satisfaction, the number of problems in nursing document quality management, and nurses' enthusiasm were compared between the two groups.

Results

The scores of relationships and family and work balance were greater than those of the control group. The nursing quality result suggested the nursing quality of gynecological operation area, emergency operation area, comprehensive operation area, and surgical operation area in research nurses was significantly better than the control cases (P < 0.05). The quality management of nursing documents showed that the number of problems in nursing documents such as nursing record displayed fewer than control group (P < 0.05). The personal quality-controlled checking in medical department showed that the points of ward governance, head nurse management quality control examination, first-level nursing, recovery, publications on therapeutics, pill governance, and healthcare documentation in the research group were higher than control group (P < 0.05). The teamwork ability implied the scores of interpersonal communications, problem definition, project division, team evaluation assistance and motivation, data collection, interpretation, and extraction of results in the observation group were remarkably greater than those of control group (P < 0.05). The satisfaction mark showed that the scores of care information exchange, advanced technologies, attitude towards care providing, healthcare establishing, knowledge publicity, and learning in the researches were markedly more than those of the control group (P < 0.05).

Conclusion

Compared with the traditional clinical nursing management, the use of the PDCA circulation management mode can effectively improve the quality of hospital nursing work, strengthen nurses' ability of teamwork, improve nurses' work efficiency and enthusiasm, enhance their sense of achievement of clinical nursing work, then improve patient satisfaction, and enhance the reputation and competitiveness of hospitals. Therefore, the PDCA management model is worth popularizing and applying in clinic.

Study on the Effect of PDCA Circulation Method on Nursing Quality Management in the Day Operating Room

Objective

The main objective is to investigate the effect of PDCA circulation management on nursing quality in the day operation room.

Methods

A retrospective study was performed in 300 patients in the day surgery room. For the control group, 150 patients received routine nursing. For the observation group, 150 patients underwent PDCA circulation nursing management. The scores for nursing quality management, the hospital infection, the detection rate of pathogenic bacteria, the incidence rate of adverse events, the negative emotion of patients, and the satisfaction rate for the day surgery department were recorded and analyzed between two groups.

Results

Compared with the control group, the scores for nursing quality management and the satisfaction rate for the day surgery department were significantly increased (all P < 0.05), while the hospital infection, the detection rate of pathogenic bacteria, HAMA scores, HAMD scores, and the incidence rate of adverse events were obviously decreased (all P < 0.05). Significantly statistical differences were observed between the two groups.

Conclusion

PDCA circulation nursing management in the day operating room could optimize the nursing quality management, improve the satisfaction rate of the operating room, reduce the negative emotions of patients, and prevent adverse events in time, with lower hospital infections.

A PDCA Model for Disinfection Supply Rooms in the Context of Artificial Intelligence to Reduce the Incidence of Adverse Events and Improve the Disinfection Compliance Rate

As an important section for controlling hospital infection, the main responsibility of the sterilization supply room is to clean, disinfect, sterilize, store, and distribute all medical devices that need to be reused in the hospital, and the quality of its work is closely related to the normal work of the hospital. Disinfection and supply department is the premise and foundation of the hospital department, mainly responsible for the recovery, cleaning, disinfection, sterilization, storage, and distribution of medical devices. The cleaning and disinfection work is characterized by strong technicality and high requirements, and the work effect is directly related to the safety of patients' lives and the occurrence of hospital infections. Therefore, there is an urgent need for a scientific and efficient management mode to be applied to the work of the supply room. The traditional management mode has some drawbacks, which affects the actual work of the hospital. Disinfection and supply rooms are an important part of hospital infection control and an important department to ensure the quality of health care. An effective management mode can not only improve the efficiency but also the overall quality of work, and PDCA (plan-do-check action cycle) as an advanced management mode can effectively improve the quality of management. This study investigates the effect of PDCA cycle management based on artificial intelligence algorithms in the nursing management of sterile supply rooms, and the experimental results show that the algorithm model can effectively reduce the incidence of adverse events and improve the rate of sterilization standards, which has certain practical significance.

Short and Concise Peer-to-Peer Teaching—Example of a Successful Antibiotic Stewardship Intervention to Increase Iv to Po Conversion

Antibiotic stewardship (ABS) programs aim to combine effective treatment with minimized antibiotic-related harms. Common ABS interventions are simple and effective, but their implementation in daily practice is often difficult. The aim of our study was to investigate if a single, short, peer-to-peer teaching intervention (junior doctor to junior doctor) during clinical routine can successfully improve antibiotic prescriptions. We performed a quasi-experimental before–after study on a regular care cardiology ward at a large academic medical center in Germany. We evaluated antibiotic use metrics retrospectively and calculated defined daily doses (DDD) with the anatomical therapeutic chemical/DDD classification system of the World Health Organization. We hypothesize that the over-representative use of intravenous administration is a potentially modifiable target, which can be proven by antibiotic use metrics analysis. After a single peer-to-peer teaching session with a focus on indications for iv to po conversion, the normalized percentage of intravenous compared to oral administration significantly decreased (from 86.5 ± 50.3% to 41.4 ± 70.3%). Moreover, after the intervention, antibiotics with high oral bioavailability were no longer administered intravenously at all during the following quarter. Our results indicate that even a single peer-to-peer training session is highly effective in improving the iv to po conversion rate in the short term.

Influence of Fine Management Combined With PDCA Cycle Method on Disinfection Qualified Rate and Performance Grade of Ophthalmic Precision Instruments

Objective

The aim of this study is to explore the influence of fine management combined with the plan-do-check-action (PDCA) cycle method on the management of ophthalmic precision instruments.

Methods

The ophthalmic precision instruments centralized in the disinfection supply room of our hospital were selected as the research objects and divided into groups A and B. Traditional instrument management method was adopted in group A, and fine management combined with the PDCA cycle method based on the group A was adopted in group B. The instrument management risk scores, the qualified rate of disinfection, instrument performance grade, and incidence of toxic anterior segment syndrome (TASS) of the two groups were compared.

Results

The risk scores of instrument management and incidence of TASS in group B were lower than those in group A (p < 0.05). The qualified rate of disinfection and instrument performance grades in group B were higher than those in group A (p < 0.05).

Conclusion

Fine management combined with the PDCA cycle method can improve the qualified rate of disinfection of ophthalmic precision instruments, optimize the performance of instruments, reduce the risk of instrument management, and reduce the incidence of TASS.