目的:探讨新疆维吾尔自治区人民医院实施临床路径管理的变异情况和持续改进策略.方法:选取该院实施临床路径患者464例,详细记录并说明变异情况,按不同评价方法对变异进行分析.结果:正性变异发生率为4.63%,负性变异发生率为44.13%;疾病转归造成的变异发生率为30.6%,医务人员造成的变异发生率为32.03%,医院系统造成的变异发生率为22.42%,病人需求变化造成的变异发生率为6.76%;可控变异发生率为35.23%,小可控变异发生率为64.77%.结论:分析临床路径变异情况,有利于医疗质量持续改进,并为科学制定临床路径提供依据.%Objectlves: To analyze the variance factors and management measures of clinical pathway applied.Methods: Select 464 patients of clinical pathway in the hosipilal record and describe variance factors, analyze the variance factors according to different methods of evaluation.Results: The incidence of positive variance was 4.63％, the incidence of negative variance was 44.13％ ; the incidence of disease outcome was 30.6％, the incidence of medical staff was 32.03％ , the incidence of hospital system was 22.42％ , the incidence of demand of patients was 6.76％; the incidence of controllable variance factors was 35.23％, the incidence of uncontrollable variance factors was 64.77％.Conclusion: The results suggest that analysis of clinical paihway variance factors are beneficial for continuous medical quality improvement and of fer the scientiflc evidence for developing clinical pathway.
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