average hospitalization day influencing factors countermeasures
江苏现代医院管理研究中心医院管理研究课题（JSY-3-2019-01）
目的：了解盐城市某三甲医院2016—2018年平均住院日情况，对三年未达院部指标的科室进行原因分析，提出缩短平均住院日的有效对策。方法：收集某三甲医院2016—2018年各临床科室平均住院日数据，进行横向和纵向比较，与院部每年设定的科室平均住院日标准比较，查找三年未达标的和影响医院平均住院日较大的临床科室；运用问卷调查，找出影响平均住院日较大的医技科室；另外院部指令对缩短平均住院日有监管责任的职能科室，进行PDCA持续改进平均住院日。结果：经过全院各科室全员参与讨论，找到影响医院平均住院日的主要原因有入院、出院标准把控不严，医疗技术水平不够，医技检查等候时间长，未完全建立与基层、社区医院的转诊机制。结论：各科室运用PDCA管理工具进行持续改进，针对影响本科室平均住院日的主要原因采取有效对策，如加强核心制度的落实，不断提高医疗技术，开展新技术；加强患者住院期的管理；畅通医院与基层、社区转诊渠道；外科手术患者术前安排在门诊检查；缩短医技科室检查等候时间等。
Objective：to explore the average hospitalization day of a grade A tertiary hospital in Yancheng 2016-2018 years，and to analyze the reasons for the departments that have not reached the hospital index in three years，and to put forward effective countermeasures to shorten the average hospitalization day. Methods：The average hospitalization day of each clinical department in a grade A tertiary hospital in 2016-2018 was collected，compared horizontally and vertically，compared with the average inpatient day standard set by the hospital each year.The reasons for the clinical departments which could not reach the hospital standard were ananlyzed. By means of questionnaire survey，this study found out the medical and technical departments that affected the average hospital days. The administrative department carried out PDCA for continuous improvement of the average hospitalization days. Results：The main reasons affecting the average hospital hospitalization days were summarized through the participation and discussion of all the departments in the whole hospital. Conclusions: The departments use PDCA management tools to make continuous improvement，and put forward some countermeasures for the main reasons that affect the average hospitalization days of the departments.