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减少医用直线加速器停机时间的持续质量改进项目：以浙江省肿瘤医院为例

Continuous quality improvement project to reduce the downtime of medical linear accelerators: A case study at Zhejiang Cancer Hospital.

作者信息

Lu Qi-Peng, Wu Yong, Mao Xiao-Dong, Wan Hua-Jun, Shao Jian, Yu Qi-Kai, Zhang Wei, Zhao Yue, Wang Ci-Yong

机构信息

Department of Medical Engineering, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), 310022, Hangzhou, China.

Department of Purchasing, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), 310022, Hangzhou, China.

出版信息

Heliyon. 2024 May 3;10(9):e30668. doi: 10.1016/j.heliyon.2024.e30668. eCollection 2024 May 15.

DOI:10.1016/j.heliyon.2024.e30668
PMID:38774097
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11107096/
Abstract

OBJECTIVE

To analyse and continually improve existing issues in the quality improvement process of medical linear accelerators (LINACs) and enhance the quality control management of LINACs.

METHODS

Data were collected from eight LINACs (sourced from three manufacturers) at Zhejiang Cancer Hospital using Excel diaries between January 2019 and December 2020. The data description and analysis were performed using the analytic hierarchy process, SPSSAU and Excel software, and mean-time-to-repair (MTTR)/mean-time-between-failure (MTBF) metrics. Continuous quality improvement was executed using the quality control circle (QCC) quality management method.

RESULTS

After quality improvement, the risk frequency of 'LINAC down' events decreased by 43.63% and downtime was reduced by 40.45%. The weight of downtime risk improved by 73.69%. The MTTR recovery value increased by 31.90%, and MTBF reliability increased by 2.97 h. The simulation results demonstrated that the proposed quality improvement measures could effectively decrease the frequency and duration of downtimes, consequently extending the normal operational time of LINACs.

CONCLUSION

Transitioning from instant repair to preventative maintenance can enhance the operational efficiency of equipment and yield economic benefits for hospitals. The QCC method and the event risk evaluation model are effective in reducing the downtime of LINACs and improving their quality control management.

摘要

目的

分析并持续改进医用直线加速器（LINAC）质量改进过程中存在的问题，加强LINAC的质量控制管理。

方法

2019年1月至2020年12月期间，使用Excel日志从浙江大学医学院附属肿瘤医院的八台LINAC（来自三个制造商）收集数据。使用层次分析法、SPSSAU和Excel软件以及平均修复时间（MTTR）/平均无故障时间（MTBF）指标进行数据描述和分析。采用质量控制圈（QCC）质量管理方法进行持续质量改进。

结果

质量改进后，“LINAC停机”事件的风险频率降低了43.63%，停机时间减少了40.45%。停机风险权重提高了73.69%。MTTR恢复值提高了31.90%，MTBF可靠性提高了2.97小时。模拟结果表明，所提出的质量改进措施可有效降低停机频率和持续时间，从而延长LINAC的正常运行时间。

结论

从即时维修过渡到预防性维护可提高设备运行效率，为医院带来经济效益。QCC方法和事件风险评估模型可有效减少LINAC的停机时间，提高其质量控制管理水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/b5bb44be336e/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/19290475a1a6/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/205e9d655cfa/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/c87d0ccee924/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/5174697052f3/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/b29a1d77e46f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/b5bb44be336e/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/19290475a1a6/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/205e9d655cfa/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/c87d0ccee924/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/5174697052f3/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/b29a1d77e46f/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06b9/11107096/b5bb44be336e/gr6.jpg

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