目的

探讨品管圈在提升超声诊断子宫肌瘤准确率中的应用效果。

方法

珠海市人民医院超声影像科于2022 年9 月开展品管圈活动，通过制定活动主题和活动计划，根据超声医师不同职称级别分为初级、中级、高级3 个医师组，每组各随机抽取6 名医师，共18 名医师，收集每名医师于2021 年4 月至2022 年9 月诊断子宫肌瘤的病例，参考手术记录和术后病理进行验证，统计其诊断及分型的符合率，对诊断错误原因进行分类分析，拟定对策并设定品管圈活动目标。于2022年10 月至2024 年3 月期间持续实施品管圈质量控制，统计品管圈活动实施后所有医师的超声诊断准确率、目标达标率和进步率，最后总结及分析从而改进质量控制方案。采用Wilcoxon 秩检验比较活动实施前后诊断准确率的差异。

结果

品管圈活动实施后，所有超声医师诊断准确率较活动前均有提升（43.8%～66.7% vs 46.2%～81.8%，Z=-3.52，P＜0.001），目标达标率为53.2%，进步率为14.7%；初级组、中级组、高级组医师超声诊断准确率均较活动前提高（初级组：46.2%～58.6%vs 40.0% ～50.0%； 中级组：55.3% ～72.3% vs 40.0% ～53.8%； 高级组：63.0% ～81.8% vs 50.0%～66.7%），差异均具有统计学意义（Z=-2.032、-2.214、-2.023，P=0.042、0.027、0.043）。

结论

品管圈在提升超声诊断子宫肌瘤准确率方面是有效的。

Objective

To evaluate the value of quality control circle in improving the accuracy of ultrasound diagnosis of uterine fibroids.

Methods

The Department of Ultrasound Imaging of Zhuhai People’s Hospital launched a quality control circle activity in September 2022.After establishing a theme and plan for the activity, physicians were divided into three groups based on their professional titles: junior,intermediate, and senior.Six physicians were randomly selected from each group, totaling 18 physicians.Cases of uterine fibroids diagnosed by these physicians between April 2021 and September 2022 were collected and verified against surgical records and postoperative pathology.Diagnostic accuracy and classification rates were statistically analyzed, while diagnostic errors were categorized and investigated.Countermeasures were formulated, and activity goals were established.From October 2022 to March 2024,continuous quality control circle activity was implemented.Post-intervention diagnostic accuracy rates,target achievement rates, and improvement rates were statistically analyzed.Pre- versus post-intervention diagnostic accuracy rates were compared using the Wilcoxon test.

Results

Following quality control circle activity implementation, diagnostic accuracy rates increased relative to pre-intervention values (43.8%-66.7% vs 46.2%-81.8%), with a target achievement rate of 53.2% and improvement rate of 14.7%.Diagnostic accuracy significantly increased across all professional tiers (junior: 46.2%-58.6% vs 40.0%-50.0%,Z=-2.032, P=0.042; intermediate: 55.3%-72.3% vs 40.0%-53.8%, Z=-2.214, P=0.027; senior: 63.0%-81.8% vs 50.0%-66.7%, Z=-2.023, P=0.043).

Conclusion

Quality control circle activity implementation effectively improves the accuracy of ultrasound diagnosis of uterine fibroids.