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危急值报告全链管理系统的开发与评估

Development and evaluation of a whole-chain management system for critical value reporting.

作者信息

Wu Dongdong, Zhu Feng, Sheng Yifan, Zhang Weiwei, Le Hanbo, Zhang Guoqiang, Wang Lei, Yan Boer

机构信息

Department of Geriatric and Integrated Chinese and Western Medicine, Zhoushan Hospital, Zhoushan, China.

Department of Hematology, Zhoushan Hospital, Zhoushan, China.

出版信息

BMC Med Inform Decis Mak. 2025 Feb 27;25(1):104. doi: 10.1186/s12911-025-02936-6.

DOI:10.1186/s12911-025-02936-6
PMID:40016752
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11869711/
Abstract

BACKGROUND

Critical value (CV) management is vital for patient safety and shows the quality of critical care. This study aimed to develop a whole-chain management system (WCMS) for CV reporting and evaluate its impact on clinical practice.

METHODS

A WCMS for CV reporting, considering sample, process and patient population, was developed. A quasi-experimental study was conducted at Zhoushan Hospital. 591 CVs were divided into two groups: the postapplication group (n = 298) and the preapplication group (n = 293). CV quality-related indicators were compared between the two groups, including the timely reporting rate, timely receiving rate, timely treatment rate, completeness of treatment records and closed-loop rate.

RESULTS

Before system implementation, the timely treatment rate (93.17%), completeness of treatment records (78.16%), and closed-loop rate (88.05%) were lower than the timely reporting rate (94.54%). After implementation, there were significant differences between the two groups in timely reporting rate (94.54% vs. 97.99%, P < 0.05), timely treatment rate (93.17% vs. 97.65%, P < 0.01), completeness of treatment records (78.16% vs. 94.97%, P < 0.01), and closed-loop rate (88.05% vs. 97.32%, P < 0.01).

CONCLUSION

Implementing the WCMS from sample, process and patient population has improved patient safety. The system's successful integration also shows its potential for use in health information systems of various healthcare facilities.

摘要

背景

危急值（CV）管理对患者安全至关重要，体现了重症监护的质量。本研究旨在开发一个用于CV报告的全链管理系统（WCMS），并评估其对临床实践的影响。

方法

开发了一个考虑样本、流程和患者群体的CV报告WCMS。在舟山医院进行了一项准实验研究。591个危急值被分为两组：应用后组（n = 298）和应用前组（n = 293）。比较两组CV质量相关指标，包括及时报告率、及时接收率、及时治疗率、治疗记录完整性和闭环率。

结果

在系统实施前，及时治疗率（93.17%）、治疗记录完整性（78.16%）和闭环率（88.05%）低于及时报告率（94.54%）。实施后，两组在及时报告率（94.54%对97.99%，P < 0.05）、及时治疗率（93.17%对97.65%，P < 0.01）、治疗记录完整性（78.16%对94.97%，P < 0.01）和闭环率（88.05%对97.32%，P < 0.01）方面存在显著差异。

结论

从样本、流程和患者群体实施WCMS提高了患者安全。该系统的成功整合也显示了其在各种医疗机构健康信息系统中应用的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/82e58fa270e7/12911_2025_2936_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/40a72c130295/12911_2025_2936_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/db89894bee70/12911_2025_2936_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/a96882952dc8/12911_2025_2936_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/080c89d05928/12911_2025_2936_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/ea2c1bd9570e/12911_2025_2936_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/a7a5209f8665/12911_2025_2936_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/82e58fa270e7/12911_2025_2936_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/40a72c130295/12911_2025_2936_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/db89894bee70/12911_2025_2936_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/a96882952dc8/12911_2025_2936_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/080c89d05928/12911_2025_2936_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/ea2c1bd9570e/12911_2025_2936_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/a7a5209f8665/12911_2025_2936_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada2/11869711/82e58fa270e7/12911_2025_2936_Fig7_HTML.jpg

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本文引用的文献

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The Application Value of the D-Dimer Critical Value in Diagnosing Deep Vein Thrombosis in Patients with Bone Trauma.D-二聚体危急值在诊断骨创伤患者深静脉血栓中的应用价值。
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APTT critical value establishment in four different reagent/instrument systems based on single factor deficiencies.基于单因素缺乏的四种不同试剂/仪器系统中 APTT 危急值的建立。
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Construction and Application of Chain Management Information System for Cancer Pain.
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Pain Manag Nurs. 2023 Aug;24(4):e75-e80. doi: 10.1016/j.pmn.2023.04.004. Epub 2023 May 17.
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Association of Critical Value With 28-Day Mortality After Cardiac Surgery.关键值与心脏手术后 28 天死亡率的关联。
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Evaluation of a Newly Implemented Critical Thromboelastography (TEG) Value Callback System.新实施的危急血栓弹力图（TEG）值回调系统的评估
Am J Clin Pathol. 2022 Dec 1;158(6):667-671. doi: 10.1093/ajcp/aqac114.
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