医院管理

基于药品集中带量采购政策下的医院药品供应保障的现状及对策分析

Analysis of the current situation and countermeasures of hospital drug supply guarantee based on the policy of centralized and volume-based procurement

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       目的 分析药品集中带量采购(集采)政策下医院药品供应保障实况,提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据,描述性统计分析集采药品供应情况。结果 采购的416个中标药品中,69个在购销合同期内短缺,短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关,季节性强,以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力,保障供应。
   Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement(hereinafter referred to as “central procurement”),and proposes optimization strategies and suggestions for the policy and guarantee.Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024,descriptive statistical analysis of the drug supply situation through centralized procurement was conducted.Results Among the 416 selected drugs purchased,69 were in short supply during the contract period,with a shortage rate of 16.59%.The reasons for the shortage were related to the production capacity of the enterprise,seasonal demand fluctuations,strong seasonality,and mainly chronic diseases and anti-infective.Conclusions It is suggested to build a monitoring platform,improve the reporting system,formulate emergency plans,and evaluate the supply capacity to ensure supply.

清咳平喘颗粒联合乙酰半胱氨酸治疗痰热闭肺型大叶性肺炎患儿的临床疗效研究

Clinical efficacy of Qingke Pingchuan granules combined with acetylcysteine in the treatment of children with lobar pneumonia of phlegm-heat obstructing lung type

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目的 探讨清咳平喘颗粒联合乙酰半胱氨酸对痰热闭肺型大叶性肺炎(LP)患儿的治疗效果。方法 回顾性选取我院收治的118例痰热闭肺型LP患儿(选例时间:2023年1月~2025年11月)为研究对象,根据治疗方案分为参照组(59例,采用乙酰半胱氨酸治疗)、联合组(59例,采用清咳平喘颗粒联合乙酰半胱氨酸治疗)。对比两组临床疗效、不良反应及治疗前、后肺功能[潮气量(VT)、达峰时间比(TPTEF/TE)、吸呼比(Ti/Te)、达峰容积比(VPEF/VE)]、中医证候、免疫功能、炎症因子[白细胞介素-8(IL-8)、趋化因子配体3(CCL3)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)]水平。结果 联合组总有效率为96.61%,高于参照组的83.05%(P<0.05);与参照组相比,治疗后联合组各中医证候积分均较低(P<0.05);联合组治疗后VT、TPTEF/TE、Ti/Te、VPEF/VE水平均较参照组高(P<0.05);联合组治疗后CD8+水平较参照组低,CD3+、CD4+、CD4+/CD8+水平较参照组高(P<0.05);治疗后联合组血清IL-8、CCL3、TNF-α、HMGB1水平均较参照组低(P<0.05);不良反应发生情况组间比较,无明显差异(P>0.05)。结论 清咳平喘颗粒联合乙酰半胱氨酸可提高痰热闭肺型LP患儿治疗效果,减轻临床症状,改善肺功能、免疫功能,降低机体炎症反应程度。
Objective To explore the therapeutic efficacy of Qingke Pingchuan granules combined with acetylcysteine on children with lobar pneumonia (LP) of phlegm-heat obstructing lung type. Methods A total of 118 children with LP of phlegm-heat obstructing lung type admitted to our hospital from January 2023 to November 2025 were retrospectively selected as the research subjects. According to different treatment regimens, they were divided into the control group (59 cases, treated with acetylcysteine) and the combined group (59 cases, treated with Qingke Pingchuan granules combined with acetylcysteine). The clinical efficacy, adverse reactions, as well as the levels of pulmonary function indicators [tidal volume (VT), time to peak tidal expiratory flow ratio (TPTEF/TE), inspiration-expiration ratio (Ti/Te), volume to peak tidal expiratory flow ratio (VPEF/VE)], traditional Chinese medicine (TCM) syndrome scores, immune function and inflammatory factors [interleukin-8 (IL-8), C-C motif chemokine ligand 3 (CCL3), tumor necrosis factor-α (TNF-α), high mobility group box 1 protein (HMGB1)] before and after treatment were compared between the two groups. Results The total effective rate of the combined group was 96.61%, which was higher than 83.05% of the control group (P<0.05). After treatment, the TCM syndrome scores of the combined group were lower than those of the control group (P<0.05). The levels of VT, TPTEF/TE, Ti/Te and VPEF/VE in the combined group were higher than those in the control group after treatment (P<0.05). After treatment, the level of CD8? in the combined group was lower, while the levels of CD3?, CD4? and CD4?/CD8? were higher than those in the control group (P<0.05). The serum levels of IL-8, CCL3, TNF-α and HMGB1 in the combined group were significantly lower than those in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of Qingke Pingchuan granules and acetylcysteine can enhance the therapeutic efficacy on children with LP of phlegm-heat obstructing lung type, relieve clinical symptoms, improve pulmonary function and immune function, and reduce systemic inflammatory response.

改良后本科生临床医学课堂教学评价量表的应用研究

Applied Research on the Revised Classroom Teaching Evaluation Scale for Undergraduate Clinical Medical Education

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目的 探讨改良后本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面的变化。方法 2018年9月-2019年9月选取四川大学华西医院2017级临床医学和口腔医学五年制本科生共30名,以及3名授课教师作为研究对象,将既往版、现行版以及改良版教学质量评价量表应用课堂,并采用问卷调查方法对其进行分析评估。评估经改良后的教学质量评价表在及时性、有效性和易用性方面的变化差异。结果 共计向研究对象发放99份教学质量评价量表和33份调查问卷,回收率为100%。针对授课教师能及时获取教学质量反馈,教师认为课后评教工具的最佳评价时机为课后当天晚上12点前(33.3%)或课后24小时内(66.7%),高于课后立即评价(0%)和期末评价(0%)。对三个版本教学评价表问卷调查结果显示,改良版教学评价量表的时效性、有效性和易用性为优的比例分别为86.67%,60%和76.67%,均高于现行版的43.33%,60%和46.67%,同时均高于既往版的23.33%,23.33%和36.67%,差异有统计学意义(P<0.05)。结论 改良后的本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面均得以显著提高。通过不断优化量表设计和评价指标,可以提高教学质量评价的科学性和准确性。
Objective: To investigate the changes in timeliness, validity, and usability of the modified classroom teaching evaluation scale for undergraduate clinical medical education. Methods: From September 2018 to September 2019, a cohort comprising 30 fifth-year undergraduate students majoring in clinical medicine and stomatology from West China Hospital, Sichuan University, along with three faculty instructors, was enrolled. Three versions of teaching evaluation scales (historical, current, and modified) were implemented in classroom settings, followed by questionnaire-based comparative analyses. The revised scale was systematically assessed for improvements in feedback timeliness, measurement validity, and operational usability. Results: A total of 99 evaluation forms and 33 questionnaires were distributed, with a 100% response rate. Regarding timely feedback acquisition, faculty preferred receiving evaluations by midnight on the teaching day (33.3%) or within 24 hours post-class (66.7%), outperforming immediate

利多卡因联合艾司氯胺酮对肺部手术患者苏醒质量及术后认知功能的影响

Effects of lidocaine combined with esketamine on recovery quality and postoperative cognitive function in patients undergoing lung surgery

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目的:探讨利多卡因复合艾司氯胺酮对肺部手术患者苏醒质量及认知功能的影响。方法:选取2023年7月至2025年6月本院收治的100例拟行肺部手术患者,按随机数字表法分为观察组和对照组,各50例。对照组采用常规麻醉方案维持麻醉,观察组在常规麻醉基础上复合利多卡因及艾司氯胺酮辅助麻醉。比较两组患者苏醒质量[拔管后30min Riker镇静躁动评分(SAS)、苏醒时间、拔管时间]、认知功能[术前及术后1d、3d简易精神状态检查表评分(MMSE)]、围术期血流动力学指标[麻醉药物输注前(T0)、气管插管时(T1)、拔管后5min(T2)平均动脉压(MAP)、心率(HR)]及术后72h不良反应发生率。结果:观察组拔管后30min SAS评分、术后1d、3d的MMSE评分高于对照组,苏醒时间、拔管时间低于对照组;观察组T0、T1、T2各时间点MAP、HR无显著差异(P>0.05);对照组T1、T2时MAP、HR高于T0(P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论:利多卡因复合艾司氯胺酮应用于肺部手术,可提升患者苏醒质量、保护术后认知功能,维持围术期血流动力学稳定,且安全性良好。
Objective : To investigate the effect of lidocaine combined with esketamine on recovery quality and cognitive function in patients undergoing lung surgery. Methods : A total of 100 patients receiving pulmonary resection at our hospital between July 2023 and December 2025 were enrolled and randomized via a random number table into two equal arms (n=50 per group): observation and control. The control group was treated with routine anesthesia to maintain anesthesia, and the observation group was treated with lidocaine and esketamine on the basis of routine anesthesia. The recovery quality [ Riker sedation agitation score ( SAS ) at 30 min after extubation, recovery time, extubation time ], cognitive function [ simple mental state examination score ( MMSE ) before operation and 1 d, 3 d after operation ], perioperative hemodynamic indexes [ mean arterial pressure ( MAP ), heart rate ( HR ) before anesthesia drug infusion ( T0 ), tracheal intubation ( T1 ), 5 min after extubation ( T2 ) ] and the incidence of adverse reactions at 72 h after operation were compared between the two groups. Results : In the observation group, the SAS score measured 30 minutes post-extubation and the MMSE scores at 1 day and 3 days post-operation were significantly higher than those in the control group. Conversely, both recovery and extubation times were shorter in the observation group compared to the control group. No significant differences in MAP and HR were observed at T0, T1, and T2 within the observation group (P > 0.05). In contrast, within the control group, MAP and HR at T1 and T2 were notably elevated compared to T0, with the differences being statistically significant (P < 0.05). Conclusion : The application of lidocaine combined with esketamine in lung surgery can improve the quality of recovery, protect postoperative cognitive function, maintain perioperative hemodynamic stability, and has good safety.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative diagnostic value of 99mTc-MIBI SPECT/CT dual-phase imaging and ultrasound in preoperative localization of secondary hyperparathyroidism

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目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

99mTc-MIBI SPECT/CT双时相显像与超声在继发性甲状旁腺功能亢进症术前定位中的诊断价值对比研究

Comparative Diagnostic Value of 99mTc-MIBI SPECT/CT Dual-Phase Imaging and Ultrasound in Preoperative Localization of Secondary Hyperparathyroidism

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目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描(???Tc-MIBI SPECT/CT)双时相显像与颈部超声在继发性甲状旁腺功能亢进症(SHPT)患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准,计算超声与SPECT/CT在区域层面(共216个区域)的敏感性、特异性、准确性,并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例(83.33%)。超声诊断敏感性、特异性、准确性分别为70.89%(112/158)、86.21%(50/58)、75.00%(162/216);SPECT/CT分别为92.41%(146/158)、94.83%(55/58)、93.06%(201/216)。SPECT/CT的敏感性和准确性均高于超声(P均<0.001)。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声(P<0.05)。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声,尤其对左上、左下、右上区域病灶检出优势明显,可作为SHPT患者术前定位的重要补充或首选影像学方法。
Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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目的 探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

:-
 
探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.
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