广西医学

目的了解广西公立医院医疗质量监督管理的实际状况，为进一步完善公立医院医疗质量监督管理体系提供参考。方法采用问卷调查法对广西14个设区市的323家二、三级公立医院（三级医院99家、二级医院224家）进行医疗质量监督管理现状调查。结果有320家（99.07%）公立医院实行两级及以上质量管理组织架构。51.08%（165/323）的医院创办有质量安全月刊，95%以上的医院组织过医务人员进行相关考核，90.71%（293/323）的医院将医疗质量相关总结、指标、培训等完成情况与科室绩效考核挂钩。在院级层面，21.05%（68/323）的医院每月召开1次或多次医疗质量管理会议；在科级层面，仅6.50%（21/323）的医院实现科室负责人每周组织一次医疗质量管理会议。97.21%（314/323）的医院开展过质量安全培训，但还有2.79%（9/323）的医院从未开展过质量安全培训。三级医院常用的质量管理工具为临床路径管理（占93.94%）和PDCA循环（占91.92%），二级医院为临床路径管理（占80.36%）。仅有25.38%（82/323）的医院建设有医疗质量信息化监管平台。结论广西公立医院医疗质量管理面临管理组织协同不充分、监管机制不健全、支撑保障能力不足等问题，且缺乏动力机制、激励机制。应促进医疗质量管理组织协同、完善医疗质量监督管理机制、加强医疗质量支撑保障建设。

Objective To understand the actual situation of medical quality supervision and management of Guangxi public hospitals, so as to provide references for further improving medical quality supervision and management system of public hospitals. Methods The current status of medical quality supervision and management in 323 class Ⅱ and Ⅲ public hospitals (99 class Ⅲ hospitals and 224 class Ⅱ hospitals) in 14 cities of establishing districts in Guangxi was investigated by questionnaire. Results There were 320 (99.07%) public hospitals with two or more levels of quality management organization. Hospitals in 51.08% (165/323) had established a monthly quality and safety magazine, more than 95% hospitals had organized medical personnel to conduct relevant assessments, and 90.71% (293/323) hospitals linked the completion of medical quality⁃associated summaries, indices, training, etc., with the performance evaluation of their departments. At the hospital level, 21.05% (68/323) hospitals held one or more meetings of medical quality management per month; in addition, at the department level, only 6.50% (21/323) hospitals had realized a weekly meeting of medical quality management organized by department heads. Hospitals in 97.21% (314/323) had carried out quality and safety training, but 2.79% (9/323) hospitals had never carried out quality and safety training. The commonly used quality management tools in class Ⅲ hospitals were clinical pathway management (accounting for 93.94%) and PDCA cycle (accounting for 91.92%), and in class Ⅱ hospitals was clinical pathway management (accounting for 80.36%). Only 25.38% (82/323) hospitals had established platform for medical quality information⁃based supervision. Conclusion The medical quality management of Guangxi public hospitals is faced with such problems as insufficient coordination of management and organization, imperfect supervision mechanism, and insufficient support and guarantee capacity, as well as a lack of motivation mechanism and incentive mechanism. It is recommended to promote the organization and coordination of medical quality management, improve the supervision and management mechanism of medical quality, and strengthen the construction of medical quality support and guarantee.