冲程(发动机)
医学
离群值
急诊医学
溶栓
差异(会计)
急性中风
质量管理
统计过程控制
样本量测定
物理疗法
过程(计算)
统计
内科学
计算机科学
运营管理
护理部
急诊科
人工智能
业务
经济
工程类
会计
管理制度
心肌梗塞
操作系统
机械工程
数学
作者
Michael Dobbs,Prashanth Krishnamohan,Gregory A. Jicha,Amy Cohen
出处
期刊:Quality management in health care
[Ovid Technologies (Wolters Kluwer)]
日期:2015-07-01
卷期号:24 (3): 135-139
被引量:1
标识
DOI:10.1097/qmh.0000000000000064
摘要
Stroke care, admission through discharge, is a process that should lead to symptomatic improvement. Improvement or decline in conditions of patients with acute stroke during hospitalization can be measured by the National Institutes of Health Stroke Scale (NIH Stroke Scale or NIHSS) at both admission and discharge and may indicate the overall quality of acute stroke care for a patient and the stability of care in the system. Shewhart control charts were analyzed for 98 patients with stroke admissions in a random sample at a tertiary care stroke center to determine the feasibility of examining the NIHSS score change to detect statistical control or identify excess variance in outcomes. The study sample showed a mean improvement of 1.33 points from admission to discharge on the NIHSS. Three statistical outliers were found. Excess statistical variation clustered within a specific stroke team's tenure suggested a need for targeted education and examination for process redesign. Using the NIHSS and the Shewhart control charts identified a systematic process flaw that could be targeted to improve stroke outcomes and move the delivery system toward statistical control.
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