六西格玛方法在提高输血病历质量中的作用

目的探索六西格玛管理方法在输血病历质量管理中的作用。方法以2011年1月1日-2011年12月31日期间某医院实施常规管理期间医院输血病历质量为基线组,以2012年1月1日-2012年12月31日期间实施六西格玛方法管理后输血病历质量为干预组,分别检测和比较两个时期输血病历缺陷率和输血患者平均红细胞使用量。结果基线组和干预组在医务人员数量和结构、患者数量及病种结构等方面具有可比性。干预组输血病历缺陷率从百万分之196800降至百万分之68493(χ2=38.653,P=0.000),Sigma值从2.355提高到2.984,而输血患者平均红细胞使用量从(1.8±0.9)U降低到(1.5±0.7)U(t=6.163,P=0.000)。结论六西格玛管理可显著降低输血病历缺陷率,降低输血患者平均红细胞使用量,提高输血病历质量的Sigma值。六西格玛方法可成为输血病历管理的重要措施。

Effect of Six Sigma Strategy in the Management of Medical Records with Blood Transfusion

Objective To explore the effect of Six Sigma strategy in the management of medical records with blood transfusion. Methods This study consisted of evaluation of defect proportion of medical records with blood transfusion and per-patient erythrocyte usage amount in a hospital after the institution of Six Sigma strategy （intervention group, between Jan. 1,2012, and Dec. 31, 2012） and those immediately preceding institution of the strategy （baseline group, between Jan. 1,2011, and Dec.31, 2011）. The defect proportion of medical records with blood transfusion and per-patient erythrocyte usage amount of the two groups were measured and compared. Results The two groups were well matched, with similar medical staff quantity and structure, patient total and disease structure. After institution of Six Sigma strategy, the defect proportion of medical records with blood transfusion decreased from 196800 ppm to 68493 ppm （X^2 = 38.653, P = 0.000）, as compared to baseline group, marked by a elevation in the percentage of Sigma level from 2. 355 to 2. 984. While per-patient erythrocyte usage amount decreased from （1.8 ± 0.9）units to（ 1.5± 0.7）units （ t = 6. 163, P = 0. 000）. Conclusions Six Sigma strategy could significantly decrease defect proportion of medical records with blood transfusion and was associated with decreased per-patient erythrocyte usage amount. It supports the adoption of Six Sigma as an important part of management of medical records with blood transfusion.