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基于PDCA循环管理模式构建卒中绿色通道流程及其对卒中预后的影响。

Construction of a stroke green channel process based on the PDCA cycle management model and its impact on stroke prognosis.

作者信息

Yang Yingjing, Long Shuqin, Xu Yong

机构信息

Department of Neurology, The Second Affiliated Hospital of Guizhou Medical University Kaili 556000, Guizhou, China.

Department of Gastroenterology, The Second Affiliated Hospital of Guizhou Medical University Kaili 556000, Guizhou, China.

出版信息

Am J Transl Res. 2025 Mar 15;17(3):2221-2232. doi: 10.62347/IADH6888. eCollection 2025.

Abstract

OBJECTIVE

To evaluate the impact of implementing a stroke green channel process (GCP) based on the PDCA (Plan-Do-Check-Act) cycle on stroke prognosis.

METHODS

A retrospective analysis was conducted at the Second Affiliated Hospital of Guizhou Medical University by reviewing data of 259 stroke patients from January 2021 to December 2023. Patients were divided into two cohorts: 114 patients managed by the PDCA-based GCP and 145 patients receiving standard care (non-green channel process, NGCP). Key metrics assessed included demographic data, rescue indicators, and prognostic outcomes - neurological function, life ability, and quality of life.

RESULTS

The GCP group demonstrated significantly reduced triage (P = 0.009) and computed tomography (CT) scan completion times (P = 0.042), leading to shorter hospital stay durations (P = 0.022) and fewer transfer incidents (P = 0.001). Neurological and cognitive functions improved in the GCP group, evidenced by lower National Institute of Health stroke scale (NIHSS) scores (P = 0.011) and higher Mini-Mental State Examination (MMSE) (P = 0.008) and Montreal Cognitive Assessment (MoCA) scores (P = 0.032). Functional abilities and independence also improved, with higher Activities of Daily Living (ADL) (P = 0.007) and Barthel scores (P = 0.003), alongside lower Modified Rankin Scale (mRS) scores (P < 0.001). Adverse reactions were less frequent in the GCP group (total incidence rate P < 0.001).

CONCLUSION

Implementing a stroke GCP managed with the PDCA cycle significantly improves stroke prognosis, enhancing clinical outcomes.

摘要

目的

评估基于PDCA(计划-执行-检查-行动)循环实施卒中绿色通道流程(GCP)对卒中预后的影响。

方法

对贵州医科大学第二附属医院2021年1月至2023年12月期间259例卒中患者的数据进行回顾性分析。患者分为两组:114例采用基于PDCA的GCP进行管理,145例接受标准治疗(非绿色通道流程,NGCP)。评估的关键指标包括人口统计学数据、抢救指标和预后结果——神经功能、生活能力和生活质量。

结果

GCP组的分诊时间(P = 0.009)和计算机断层扫描(CT)完成时间显著缩短(P = 0.042),住院时间缩短(P = 0.022),转科事件减少(P = 0.001)。GCP组的神经和认知功能得到改善,美国国立卫生研究院卒中量表(NIHSS)评分较低(P = 0.011),简易精神状态检查表(MMSE)(P = 0.008)和蒙特利尔认知评估量表(MoCA)评分较高(P = 0.032)证明了这一点。功能能力和独立性也有所改善,日常生活活动能力(ADL)评分(P = 0.007)和巴氏指数评分(P = 0.003)较高,改良Rankin量表(mRS)评分较低(P < 0.001)。GCP组的不良反应较少(总发生率P < 0.001)。

结论

采用PDCA循环管理卒中GCP可显著改善卒中预后,提高临床疗效。

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