Application of quality control circle in the management of early ambulation after cesarean section: An observational study

BACKGROUND

The quality control circle (QCC) model has achieved good results in clinical applications in many hospitals in China and has gained popularity. This study aims to explore the application of QCC activities on early ambulation after cesarean section.

METHODS

A QCC management group was established following standardized methods and techniques. The theme of the group was identified as "to enhance the implementation rate of the patient early ambulation after the cesarean section" through a matrix graph. The early ambulation rates after surgery of patients who received cesarean section were compared before and after QCC managements.

RESULTS

Our data suggested that the early ambulation rates after cesarean section increased from 37.5% to 81.25% after applying QCC management. The biggest factor influencing the ambulation activities 24 ± 4 hours after the surgery was patients and family members do not cooperate. In addition, outstanding improvements in terms of nurses' sense of responsibility and self-confidence, communication and teamwork capacity in the problem-solving process were observed after the establishment of QCC.

CONCLUSION

The application of QCC management had not only increase the early ambulation rates after cesarean section but also improved the quality of nursery care in general.

Quality Control Circle Practices to Improve Mask-Wearing Compliance by Patients Diagnosed with Tuberculosis During External Examinations

Objective

The purpose of this study is to examine the effect of quality control circle (QCC) activities on increasing the mask-wearing compliance of hospitalized patients diagnosed with tuberculosis (TB) during external examinations.

Methods

To assess the mask-wearing compliance of patients diagnosed with TB admitted to a ward in our hospital in 2019, who visited other departments, we conducted activities in accordance with the ten steps of the QCC. We outlined the causes of non-compliance and developed and implemented improvement plans. We compared the results obtained before and after the implementation of the QCC to assess the enhancement in patient compliance concerning wearing masks during external examinations, particularly among individuals diagnosed with pulmonary tuberculosis.

Results

The compliance rate for mask-wearing during external examinations rose from an initial 32.61% (45/138) prior to the intervention to 83.71% (149/178) following the intervention. The difference between the two groups was statistically significant (χ2 = 85.635, P < 0.001). The following countermeasures and implementation measures were formulated: (1) Increasing public health education and awareness; (2) Strengthening the training of nursing staff to enhance their knowledge; (3) Providing free surgical masks; (4) Establishing an effective monitoring system with the department of auxiliary examinations.

Conclusion

QCC interventions were significantly effective in enhancing adherence to mask-wearing protocols during external examinations of hospitalized patients with tuberculosis. Such improvements contribute substantially to the mitigation of tuberculosis transmission within clinical and healthcare environments.

Study on the application of quality control circle activity in postoperative nursing of elderly dental implants

BACKGROUND

To explore the application effect of "quality control circle" activity in postoperative nursing of elderly dental implants.

METHODS

From January 2022 to December 2022, a total of 60 elderly patients were selected and divided into an experimental group and a control group, with 30 cases in each group using the random number table method. The elderly patients with dental implants received postoperative care under the supervision of a quality control circle. The control group was treated with conventional nursing methods. The success rate, postoperative complications, and satisfaction of the 2 groups were compared.

RESULTS

By comparing the postoperative care effect of the 2 groups of patients, the satisfaction of the experimental group and the control group was 93.3% and 73.3%, respectively, showing the satisfaction of the experimental group was higher than the control group (P < .05). The planting success rate of the experimental and control groups were 96.7% and 66.7%, respectively, with the experimental group outperforming the control group (P < .05). The proportion of complications in the experimental was found to be fewer (6.7%) than in the control group (33.3%) (P < .05).

CONCLUSION

Quality control circle activities can effectively improve the success rate of dental implants, reduce the occurrence of postoperative complications, improve patient satisfaction, and help medical staff in providing better treatment for patients.

A quality control circle process to improve enteral nutrition feeding support in discharged patients with colorectal cancer

Correct usage and maintenance of the enteral nutrition feeding pump system is always a challenge in nutrition support for patients with colorectal cancer (CRC). However, there are few studies on the sustained accuracy improvement of the enteral nutrition feeding system in discharged CRC patients. Here, we established a seven-month quality control circle (QCC) activity with the theme of improving the performance of home enteral feeding pumps (EFP) and examined the effect of QCC activity on the nutritional state and quality of life in discharged CRC patients. We enrolled 100 discharged CRC patients treated with home enteral nutrition from Zhejiang Cancer Hospital between March 2020 and December 2021. The patients were randomly split into two research groups: one participated in the QCC activity (n = 50) and the other did not (n = 50). QCC analysis indicated that the top 3 causes of EFP inaccurate usage are the simple and boring contents of training, various types of pumps, no examination rules, and lack of management. Furthermore, both intra- and inter-group comparisons showed that QCC significantly improved the patients' pass rate of nutrition pump operation from 52 to 70% after 1-month of activity, which gradually improved and got the highest (90%) after 3 months (p < 0.05). Interestingly, the established QCC activity significantly increased the patient-generated subjective global assessment (PG-SGA) and Barthel index (BI) scores, body fat mass (BFM) and superior longitudinal muscle (SLM) by intra- and inter-group comparisons. In this study, we clarified the main causes of inaccurate EFP usage and established a QCC process to improve the pass rate of EFP usage. It finally leads to the improvement of nutritional state and quality of life in CRC patients.

Impact of Quality Control Circle on Patient Outcomes after Hepatocellular Carcinoma Intervention: A Meta-Analysis

BACKGROUND

Hepatocellular carcinoma (HCC) is one of the most common clinical malignant tumors, and patients undergoing interventional treatment often experience emotional and physical distress in the postoperative period. This meta-analysis aimed to evaluate the effects of quality control circle (QCC) intervention on patient wareness of health education and postoperative complications following hepato-cellular carcinoma (HCC) intervention.

METHODS

A systematic search was conducted to identify relevant controlled trials on the impact of QCC on patients' knowledge of health education and complications after HCC intervention. The search was conducted using various online databases from the earliest available date to July 2022. Following inclusion and exclusion criteria, data were analyzed using RevMan 5.3 software, and the heterogeneity of the studies was explored.

RESULTS

A total of 120 articles were retrieved, and 11 controlled trials were included according to the inclusion and exclusion criteria. Meta-analysis showed that QCC reduced postinterventional fever (OR: 0.41, 95% CI: 0.26, 0.65, P = 0.0002), nausea and vomiting (OR: 0.36, 95% CI: 0.22, 0.58, P < 0.0001), abdominal pain (OR: 0.34, 95% CI: 0.20, 0.56, P < 0.0001), loss of appetite (OR: 0.37, 95% CI: 0.21, 0.68, P = 0.001), improved patient knowledge of health education (OR: 4.84, 95% CI: 3.03, 7.74, P < 0.0001), and increased patient satisfaction with nursing care (OR: 6.63, 95% CI: 4.21, 10.45, P < 0.00001). All differences were statistically significant.

CONCLUSIONS

QCC after HCC intervention can reduce postoperative fever, nausea and vomiting, abdominal pain, and loss of appetite. It also improves patient knowledge of health education and satisfaction with care.

Sustained Improvement of Appropriateness in Surgical Antimicrobial Prophylaxis with the Application of Quality Control Circle

Purpose

Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in surgical antimicrobial prophylaxis (SAP) remains unknown. This study aimed to implement QCC interventions to improve the appropriateness of SAP.

Methods

A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied.

Results

The appropriateness of antibiotic prophylaxis before (January to December 2020) and after (January to December 2021) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The overall SAP appropriateness was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P<0.01). A significant improvement (P<0.05) was also determined for each category: selection (from 78.82% to 96.06%), duration (from 90.15% to 96.46%), indication (from 94.09% to 97.64%), timing of first dose (from 96.55% to 99.21%), antimicrobial usage (from 96.8% to 99.41%), re-dosing of antimicrobial (from 96.55% to 99.21%).

Conclusion

Implementation of a QCC program can optimize the use of antibiotics and improve the appropriateness of SAP and is of practical importance to their standardization.

Application of Quality Control Circle Activity in Improving Effectiveness of Drug Intervention in Lung Cancer Patients with Moderate to Severe Pain

OBJECTIVE

Lung cancer has the highest incidence and mortality of all malignant tumors in China. Cancer pain dramatically affects patients' comfort level, causing insomnia, anorexia, anxiety, fear, depression, and a decline in the quality of life (QOL). The literature suggests a shortage of adequate cancer pain management for 59.1% of patients in China. The quality control circle (QCC) activity reflects the people-oriented core idea of management. This study aimed to assess the efficacy of QCC in enhancing the effectiveness of drug interventions in lung cancer patients with moderate to severe pain.

METHODS

From January 2019 to July 2019, lung cancer patients with moderate to severe pain were treated with drugs. The total number of drug interventions was 3072. A QCC activity was performed following the ten steps of the plan-docheck- act (PDCA) model. The reasons for the poor effectiveness of drug intervention in lung cancer patients with moderate to severe pain were analyzed. Countermeasures were designed to improve the effectiveness of drug intervention, including setting up a pain college, writing a medication education manual, and formulating operational rules for the administration of narcotic drugs. The effectiveness of drug intervention in lung cancer patients with moderate to severe pain and activity ability scores of QCC members were analyzed statistically before and after QCC activity. The effectiveness of drug intervention was investigated and compared before and after establishing the QCC.

RESULTS

After establishing the PDCA model, the effectiveness of drug intervention for moderate to severe pain in lung cancer patients increased from 56.28% to 85.29%. Members had significant improvement in problem-solving ability, responsibility, communication, coordination, self-confidence, team cohesion, enthusiasm, QCC skills, and harmony.

CONCLUSION

QCC activity can significantly improve the efficiency of drug intervention in lung cancer patients with moderate to severe pain and their quality of life.

The application of quality control circle to improve functional exercise execution rate of orthopaedic surgery patients: A SQUIRE-compliant quality-improving study

Since its application in medical institutions in China, quality control circle (QCC) has gained achievements in medical care and thus earned more attention from the administrative department of health. This paper focuses on the application of QCC (bone-strength test circle) as a new management concept and tool circle in improving the implementation rate of functional exercise in patients undergoing orthopedic surgery, which further effectively improve the accuracy and compliance of functional exercise in patients undergoing surgery, and further effectively promote the rehabilitation of patients.From July 2018 to November 2018, the management tools and statistical methods of QCC were used to compare the promotion effect of functional exercise execution rate of orthopedic surgery patients before and after QCC activities.The checklist investigated 6 key causes of functional exercise in patients undergoing orthopedic surgery, the operative rate of orthopaedic surgery in all aspects changed significantly. Among them, the factors of inadequate propaganda and education were compared before and after the improvement, which decreased by 71% after the improvement. The incorrect factors of exercise decreased by 69% after improvement, the effect was more obvious, the difference was statistically significant (P < .05). The improvement rate was 59.4%.Through this activity, functional exercise education process and functional exercise paths, and corresponding standards for various orthopedic diseases were established. At the same time, the measures such as health education for patients were strengthened, and the expected goals were effectively achieved.

Constructing a new health education model for patients with chronic hepatitis B

To explore the effects of the project-achievement quality control circle in constructing a new health education model for patients with chronic hepatitis B.The quality control circle group was established and the theme of "constructing a new health education model for patients with chronic hepatitis B" was selected. The circle staff determined that this quality control circle was of project-achievement according to the quality control story judgment table, and then carry out activities in strict accordance with the 10 steps of project-achievement quality control circle, evaluate the tangible results and non-tangible results before and after the activity.After the implementation of the activity, the health education integrity of patients with chronic hepatitis B increased from 74.75 ± 11.00 to 95.00 ± 5.55 points (P < .001). The awareness of health education increased from 71.90 ± 13.48 to 95.60 ± 2.84 points (P < .001), the satisfaction rate of health education increased from 76.60 ± 8.71 points to 98.00 ± 2.03 points (P < .001), and the evaluation rate after health education increased from 10% to 100% (P < .001).The circle members have much more confidence in quality control circle activities, the use of techniques, and the knowledge related to scientific research.

Quality control circle: a tool for enhancing perceptions of patient safety culture among hospital staff in Chinese hospitals

OBJECTIVE

To explore whether quality control circle (QCC) is associated with hospital staff's perceptions of patient safety culture (PSC).

DESIGN

A cross-sectional survey in 12 public hospitals from October to December 2018 and a longitudinal survey in one public hospital from November 2017 to November 2018.

SETTING

In 12 public hospitals from six provinces located in eastern, central and western of China, and one public hospital in eastern China.

PARTICIPANTS

In total, 811 and 102 hospital staff participated in the cross-sectional survey and the longitudinal survey, respectively. These participants included doctors, nurses, medical technicians and administrative staff.

MAIN OUTCOME MEASURES

Hospital staff's perceptions of PSC were measured by the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. The association between QCC implementation and PSC was identified by univariate analysis and multiple linear regression analysis.

RESULTS

Univariate analysis showed that the staff from hospitals that had implemented QCC received significantly higher HSOPSC scores than those from hospitals where QCC had not been implemented (3.73 ± 0.61 vs. 3.57 ± 0.41, P < 0.05). The QCC implementation was a significant predictor in the established multiple linear regression model. One year after QCC implementation, the hospital involved in the longitudinal survey scored higher in HSOPSC than before (3.75 ± 0.42 vs. 3.60 ± 0.36, P < 0.001).

CONCLUSIONS

QCC implementation was positively associated with PSC and the former could promote the establishment of the latter. It is suggested that QCC can play an active role in enhancing PSC so as to further improve patient safety management.

The Association between the Participation of Quality Control Circle and Patient Safety Culture

Promoting patient safety culture (PSC) is a critical issue for healthcare providers. Quality control circles program (QCCP) can be used as an effective tool to foster long-lasting improvements on the quality of medical institution. The effect of QCCP on PSC is still unknown. This was a retrospective study conducted with matching data. A safety attitudes questionnaire (SAQ) was used for the evaluation of PSC. The association between all scores of six subscales of SAQ and the participation QCCP were analyzed with both the Mann-Whitney and Kruskal-Wallis tests. A total of 2718 valid questionnaires were collected. Most participants of QCCP were females (78.9%), nurses (52.6%), non-supervisors (92.2%), aged <40 years old (64.8%), degree of specialist or university graduates (78%), and with work experience of <10 years (61.6%). Of all participants, the highest scores were in the dimension of safety climate (74.11 ± 17.91) and the lowest scores in the dimension of working conditions (68.90 ± 18.84). The participation of QCCP was associated with higher scores in four dimensions, namely: teamwork climate (p = 0.006), safety climate (p = 0.037), perception of management (p = 0.009), and working conditions (p = 0.015). The participation or not of QCCP had similar results in the dimension of job satisfaction and stress recognition. QCCP was associated with SAQ in subjects with the following characteristics: female, nurse, non-supervisor, aged >50 years old, higher education degrees and with longer working experiences in the hospital. In this first study on the association between each dimension of SAQ and the implementation of QCCP, we found that QCCP interventions were associated with better PSC. QCCP had no benefits in the dimensions of job satisfaction and stress recognition.

Implementation and Promotion of Quality Control Circle: A Starter for Quality Improvement in Chinese Hospitals

Purpose

To analyse the quality control circle (QCC) implementation status, tool modification and promotion in hospitals in mainland China.

Methods

Data were collected from the 2013–2018 National Quality Control Circle Competition of Chinese Hospitals. A total of 1913 participating QCCs implemented by 34,023 hospital staff from 915 hospitals across 31 provinces and municipalities were included in this study to analyse the characteristics of QCC implementation status in mainland China, using descriptive analyses.

Results

The majority of participating QCCs came from central and eastern hospitals. Most of the QCCs were carried out in tertiary hospitals and focused on themes of safety and patient care. The QCC has been modified in terms of its classification, implementation process, participation mechanism, and ways of dissemination. A series of promotion strategies have been made to promote the implementation of QCCs nationwide, including establishing a professional promotion organization, developing standardized training programmes, and organizing QCC academic events.

Conclusion

After years of promotion, QCCs are widely used in hospitals and have been modified to fit the practice of healthcare institutions. The QCC promotion strategies in China can offer valuable insights for other countries that are also making efforts to continuously improve care quality in healthcare institutions.

The application of quality control circle to improve the quality of samples: A SQUIRE-compliant quality-improving study

Since its application in medical institutions in China, quality control circle (QCC) has gained achievements in medical care and thus earned more attention from the administrative department of health.In order to improve the quality of laboratory specimens, we launched a QCC activity to solve the problems and evaluate the effect of it. The data of 30,105 unqualified specimens in our hospital were collected from February to June 2017. After the QCC activity, the data of 43,125 specimens taken from July to December 2017 were collected.The defect rate of the specimens before the QCC activity was 0.98% (297/30105), and after the QCC activity, it was 0.45% (193/43125), showing a significant statistical difference (P < .05). The achievement rate and improvement rate were 108.2% and 54.1%, respectively.After the implementation of QCC, the defect rate of specimens in clinical laboratories was significantly decreased, and the intangible factors were also improved, which demonstrated the positive effects of QCC on the quality control of specimens.

Minimization of the perianal infection rate of hematological malignancies with agranulocytosis by quality control circle activity and patient-hospital-student win-win concept

Objective

The agranulocytosis-associated perianal infection (PI) rate ranges from 60% to 100% among patients with hematopoietic malignancies. In this study, we assessed the efficacy of a quality control circle (QCC) to minimize the PI rate.

Methods

Among 274 patients with severe immunodeficiency (agranulocytosis of ≥2 weeks) in our bone marrow transplantation center, the PI rate was 17.20%. A QCC was established following the 10 steps of the plan-do-check-act (PDCA) model; this was scientifically supported by culturing the bacterial colony from patients’ perianal skin to determine the sanitization effect and interval time. Because a warm aqueous solution of potassium permanganate is recommended for sanitization, the bacterial colony culture was also used to determine the proper drug concentration, water temperature, and soaking time. All procedures were standardized. Patients, hospital staff, and medical students were enrolled into the QCC team based on the patient–hospital–student (PHS) win–win concept.

Results

After establishment of the PDCA model, the PI rate among 253 patients decreased from 17.20% to 5.93% and remained at 5.25% during the following year. The medical expenses and length of hospital stay consequently decreased.

Conclusion

The QCC and PHS win–win concept can reduce the PI rate and promote medical quality.