流程再造在多部门参与多重耐药菌感染防控中的效果
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鲁海蜃

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R197.323

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Effect of business process reengineering on multisectors’ participation in prevention and control of multidrugresistant organism infection
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    [摘要]目的探讨流程再造在提高多部门参与多重耐药菌感染管理中的效果,为医院多部门协作管理提供方法学指导。方法选取2015年7月—2017年6月共672例多重耐药菌感染管理处置相关数据,流程再造前2015年7月—2016年6月370例患者作为对照组,流程再造后2016年7月—2017年6月302例患者作为实验组,应用流程再造完善医院内多重耐药菌发现、报告、合作、处置等各个环节流程,比较应用流程再造前后各项医院感染质量评价指标的差异。结果应用流程再造后,多重耐药菌信息从检验科传送到临床科室的时间由(240±30)min缩短至(8±2)min;多重耐药菌医院感染发生率由2.39‰下降至1.56‰,多重耐药菌检出率由13.42%下降至11.09%,差异均有统计学意义(均P<0.05)。 多重耐药菌各项防控措施依从率和知晓率由58.11%~71.89%提高至84.11%~92.05%;抗菌药物使用率从53.18%下降至48.45%,使用强度DDDs值由44.76下降至38.26,治疗性抗菌药物使用前微生物送检率从46.68%上升至53.62%。结论流程再造增强了各部门参与合作程度,发挥了学科间优势互补,提高了医院感染管理效果。

    Abstract:

    ObjectiveTo investigate the effect of business process reengineering(BPR) on improving multisectors’ participation in management of multidrugresistant organism(MDRO) infection, and provide methodological guidance for hospital multisectors’ collaborative management. MethodsRelated data about management and disposal of 672 cases of MDRO infection occurred from July 2015 to June 2017 were selected, 370 patients before BPR (from July 2015 to June 2016) were as control group, 302 patients after BPR (from July 2016 to June 2017) were as a trial group, BPR was used to improve the process of detection, report, cooperation, and disposal of MDROs in hospital, various quality evaluation indexes of healthcareassociated infection before and after BPR were compared. ResultsAfter the BPR was implemented, time of MDRO information transmitted from laboratory to clinical departments shortened from (240±30)minutes to (8±2)minutes; incidence of MDRO HAI decreased from 2.39‰ to 1.56‰ , isolation rate of MDROs decreased from 13.42% to 11.09%,differences were all significant(all P<0.05). Compliance rates and awareness rates of various MDRO prevention and control measures increased from 58.11%-71.89% to 84.11%-92.05%, usage rate of antimicrobial agents decreased from 53.18% to 48.45%, defined daily doses (DDDs) of antimicrobial use density decreased from 44.76 to 38.26, specimen submission rate before antimicrobial use increased from 46.68% to 53.62%. ConclusionBPR can enhance the cooperation between different departments, give full play to the complementary advantages of interdisciplinary, and improve the efficiency of HAI management.

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鲁海蜃,刘淑运,陶梦琪,等.流程再造在多部门参与多重耐药菌感染防控中的效果[J]. 中国感染控制杂志,2018,17(3):247-251. DOI:10.3969/j. issn.1671-9638.2018.03.013.
LU Haishen, LIU Shuyun, TAO Mengqi, et al. Effect of business process reengineering on multisectors’ participation in prevention and control of multidrugresistant organism infection[J]. Chin J Infect Control, 2018,17(3):247-251. DOI:10.3969/j. issn.1671-9638.2018.03.013.

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  • 收稿日期:2017-08-25
  • 最后修改日期:2017-10-23
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  • 在线发布日期: 2018-03-28
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