

{"id":8187,"date":"2025-01-22T09:00:27","date_gmt":"2025-01-22T02:00:27","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=8187"},"modified":"2025-01-22T09:00:27","modified_gmt":"2025-01-22T02:00:27","slug":"measurement-for-improvement-do-luong-cho-cai-tien-chat-luong","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=8187","title":{"rendered":"Measurement for Improvement &#8211; \u0110o l\u01b0\u1eddng cho c\u1ea3i ti\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng"},"content":{"rendered":"\n<p class=\"has-text-align-right\"><strong>BS.CK2. L\u00ea H\u00e0 Xu\u00e2n S\u01a1n<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-right\">Tr\u01b0\u1edfng ph\u00f2ng Qu\u1ea3n l\u00fd ch\u1ea5t l\u01b0\u1ee3ng \u2013 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh<\/p>\n\n\n\n<p><strong>T\u00e0i li\u1ec7u \u201cMeasurement for Improvement\u201d \u0111\u01b0a ra m\u1ed9t c\u00e1i nh\u00ecn to\u00e0n di\u1ec7n v\u00e0 s\u00e2u s\u1eafc v\u1ec1 vai tr\u00f2 c\u1ee7a \u0111o l\u01b0\u1eddng trong c\u1ea3i ti\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng y t\u1ebf, \u0111\u1eb7c bi\u1ec7t trong b\u1ed1i c\u1ea3nh hi\u1ec7n \u0111\u1ea1i khi c\u00e1c y\u00eau c\u1ea7u v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng d\u1ecbch v\u1ee5 y t\u1ebf ng\u00e0y c\u00e0ng cao. \u0110\u00e2y l\u00e0 m\u1ed9t ch\u1ee7 \u0111\u1ec1 mang t\u00ednh chi\u1ebfn l\u01b0\u1ee3c, kh\u00f4ng ch\u1ec9 gi\u1edbi h\u1ea1n trong l\u0129nh v\u1ef1c y t\u1ebf m\u00e0 c\u00f2n c\u00f3 th\u1ec3 \u1ee9ng d\u1ee5ng r\u1ed9ng r\u00e3i trong c\u00e1c l\u0129nh v\u1ef1c qu\u1ea3n l\u00fd ch\u1ea5t l\u01b0\u1ee3ng kh\u00e1c.<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-70832373 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2025\/01\/1.png\" alt=\"\" class=\"uag-image-8190\" width=\"410\" height=\"600\" title=\"1\" loading=\"lazy\" role=\"img\" \/><\/figure><\/div>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>1. \u0110o l\u01b0\u1eddng kh\u00f4ng ch\u1ec9 l\u00e0 con s\u1ed1, m\u00e0 c\u00f2n l\u00e0 t\u01b0 duy<\/strong><\/p>\n\n\n\n<p>M\u1ed9t trong nh\u1eefng \u0111i\u1ec3m nh\u1ea5n \u1ea5n t\u01b0\u1ee3ng c\u1ee7a t\u00e0i li\u1ec7u l\u00e0 vi\u1ec7c nh\u1ea5n m\u1ea1nh r\u1eb1ng \u0111o l\u01b0\u1eddng kh\u00f4ng ch\u1ec9 \u0111\u01a1n thu\u1ea7n l\u00e0 vi\u1ec7c thu th\u1eadp v\u00e0 ph\u00e2n t\u00edch c\u00e1c con s\u1ed1, m\u00e0 l\u00e0 m\u1ed9t c\u00e1ch ti\u1ebfp c\u1eadn mang t\u00ednh t\u01b0 duy. T\u00e1c gi\u1ea3 \u0111\u00e3 kh\u00e9o l\u00e9o tr\u00edch d\u1eabn c\u00e2u n\u00f3i c\u1ee7a Edward Deming \u2013 m\u1ed9t nh\u00e0 qu\u1ea3n l\u00fd n\u1ed5i ti\u1ebfng, \u201cN\u1ebfu b\u1ea1n kh\u00f4ng th\u1ec3 \u0111o l\u01b0\u1eddng n\u00f3, b\u1ea1n kh\u00f4ng th\u1ec3 c\u1ea3i ti\u1ebfn n\u00f3,\u201d \u0111\u1ec3 \u0111\u1eb7t n\u1ec1n m\u00f3ng cho l\u1eadp lu\u1eadn. Tuy nhi\u00ean, t\u00e0i li\u1ec7u c\u0169ng b\u1ed5 sung m\u1ed9t g\u00f3c nh\u00ecn c\u00e2n b\u1eb1ng h\u01a1n khi nh\u1ea5n m\u1ea1nh r\u1eb1ng, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, vi\u1ec7c qu\u1ea3n l\u00fd v\u00e0 c\u1ea3i ti\u1ebfn kh\u00f4ng ch\u1ec9 d\u1ef1a tr\u00ean c\u00e1c ch\u1ec9 s\u1ed1 \u0111\u1ecbnh l\u01b0\u1ee3ng m\u00e0 c\u00f2n c\u1ea7n \u0111\u1ebfn c\u00e1c d\u1eef li\u1ec7u \u0111\u1ecbnh t\u00ednh v\u00e0 nh\u1eefng quan s\u00e1t th\u1ef1c t\u1ebf.<\/p>\n\n\n\n<p>\u0110i\u1ec1u n\u00e0y th\u1ec3 hi\u1ec7n s\u1ef1 ti\u1ebfn b\u1ed9 trong c\u00e1ch nh\u00ecn nh\u1eadn vai tr\u00f2 c\u1ee7a \u0111o l\u01b0\u1eddng trong y t\u1ebf. Khi ch\u1ec9 d\u1ef1a v\u00e0o c\u00e1c s\u1ed1 li\u1ec7u, h\u1ec7 th\u1ed1ng c\u00f3 nguy c\u01a1 b\u1ecf qua nh\u1eefng kh\u00eda c\u1ea1nh mang t\u00ednh c\u1ea3m x\u00fac, tr\u1ea3i nghi\u1ec7m ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 ng\u1eef c\u1ea3nh quan tr\u1ecdng. V\u00ed d\u1ee5, s\u1ef1 h\u00e0i l\u00f2ng c\u1ee7a b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 ch\u1ec9 \u0111\u01b0\u1ee3c \u0111o l\u01b0\u1eddng th\u00f4ng qua c\u00e1c kh\u1ea3o s\u00e1t, m\u00e0 c\u00f2n c\u1ea7n \u0111\u1ebfn nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ecbnh t\u00ednh nh\u01b0 ph\u1ecfng v\u1ea5n ho\u1eb7c quan s\u00e1t h\u00e0nh vi trong m\u00f4i tr\u01b0\u1eddng b\u1ec7nh vi\u1ec7n.<\/p>\n\n\n\n<p><strong>2. Gia \u0111\u00ecnh c\u00e1c ch\u1ec9 s\u1ed1 \u0111o l\u01b0\u1eddng: H\u1ec7 sinh th\u00e1i d\u1eef li\u1ec7u<\/strong><\/p>\n\n\n\n<p>M\u1ed9t \u0111i\u1ec3m \u0111\u1ed9c \u0111\u00e1o kh\u00e1c m\u00e0 t\u00e0i li\u1ec7u \u0111\u1ec1 c\u1eadp l\u00e0 kh\u00e1i ni\u1ec7m v\u1ec1 \u201cgia \u0111\u00ecnh c\u00e1c ch\u1ec9 s\u1ed1 \u0111o l\u01b0\u1eddng\u201d (family of measures). Thay v\u00ec ch\u1ec9 t\u1eadp trung v\u00e0o m\u1ed9t v\u00e0i ch\u1ec9 s\u1ed1 \u0111\u01a1n l\u1ebb, c\u00e1ch ti\u1ebfp c\u1eadn n\u00e0y \u0111\u1ec1 xu\u1ea5t s\u1eed d\u1ee5ng nhi\u1ec1u lo\u1ea1i d\u1eef li\u1ec7u kh\u00e1c nhau \u0111\u1ec3 ph\u1ea3n \u00e1nh to\u00e0n di\u1ec7n c\u00e1c kh\u00eda c\u1ea1nh c\u1ee7a c\u1ea3i ti\u1ebfn. V\u00ed d\u1ee5, \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ed9t can thi\u1ec7p y t\u1ebf, c\u1ea7n xem x\u00e9t \u00edt nh\u1ea5t ba lo\u1ea1i ch\u1ec9 s\u1ed1: t\u00ednh hi\u1ec7u qu\u1ea3 (ch\u1ec9 s\u1ed1 ch\u00ednh), s\u1ef1 tu\u00e2n th\u1ee7 (fidelity), v\u00e0 c\u00e1c t\u00e1c \u0111\u1ed9ng ph\u1ee5 kh\u00f4ng mong mu\u1ed1n (balancing measures).<\/p>\n\n\n\n<p>Kh\u00e1i ni\u1ec7m n\u00e0y kh\u00f4ng ch\u1ec9 h\u1eefu \u00edch trong y t\u1ebf m\u00e0 c\u00f2n \u00e1p d\u1ee5ng t\u1ed1t trong qu\u1ea3n tr\u1ecb n\u00f3i chung. M\u1ed9t h\u1ec7 th\u1ed1ng \u0111o l\u01b0\u1eddng to\u00e0n di\u1ec7n c\u1ea7n \u0111\u00e1nh gi\u00e1 c\u1ea3 m\u1eb7t t\u00edch c\u1ef1c l\u1eabn ti\u00eau c\u1ef1c c\u1ee7a m\u1ed9t can thi\u1ec7p, tr\u00e1nh vi\u1ec7c t\u1eadp trung qu\u00e1 m\u1ee9c v\u00e0o m\u1ed9t kh\u00eda c\u1ea1nh m\u00e0 b\u1ecf qua nh\u1eefng h\u1ec7 qu\u1ea3 kh\u00f4ng mong mu\u1ed1n. V\u00ed d\u1ee5, n\u1ebfu m\u1ed9t b\u1ec7nh vi\u1ec7n ch\u1ec9 t\u1eadp trung v\u00e0o gi\u1ea3m th\u1eddi gian ch\u1edd ph\u1eabu thu\u1eadt m\u00e0 kh\u00f4ng ch\u00fa \u00fd \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng ch\u0103m s\u00f3c h\u1eadu ph\u1eabu, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eefng h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng.<\/p>\n\n\n\n<p>Tuy nhi\u00ean, t\u00e0i li\u1ec7u c\u0169ng c\u1ea3nh b\u00e1o r\u1eb1ng vi\u1ec7c tri\u1ec3n khai m\u1ed9t h\u1ec7 th\u1ed1ng \u0111o l\u01b0\u1eddng to\u00e0n di\u1ec7n c\u1ea7n ph\u1ea3i c\u00e2n b\u1eb1ng v\u1edbi ngu\u1ed3n l\u1ef1c hi\u1ec7n c\u00f3. G\u00e1nh n\u1eb7ng \u0111o l\u01b0\u1eddng \u2013 khi qu\u00e1 nhi\u1ec1u ch\u1ec9 s\u1ed1 \u0111\u01b0\u1ee3c theo d\u00f5i m\u00e0 kh\u00f4ng mang l\u1ea1i gi\u00e1 tr\u1ecb th\u1ef1c t\u1ebf \u2013 c\u00f3 th\u1ec3 g\u00e2y m\u1ec7t m\u1ecfi v\u00e0 gi\u1ea3m hi\u1ec7u su\u1ea5t l\u00e0m vi\u1ec7c c\u1ee7a \u0111\u1ed9i ng\u0169 y t\u1ebf. Do \u0111\u00f3, vi\u1ec7c l\u1ef1a ch\u1ecdn v\u00e0 s\u1eafp x\u1ebfp c\u00e1c ch\u1ec9 s\u1ed1 \u0111o l\u01b0\u1eddng c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n m\u1ed9t c\u00e1ch kh\u00e9o l\u00e9o v\u00e0 chi\u1ebfn l\u01b0\u1ee3c.<\/p>\n\n\n\n<p><strong>3. \u1ee8ng d\u1ee5ng th\u1ef1c t\u1ebf: T\u1eeb l\u00fd thuy\u1ebft \u0111\u1ebfn th\u1ef1c ti\u1ec5n<\/strong><\/p>\n\n\n\n<p>T\u00e0i li\u1ec7u kh\u00f4ng ch\u1ec9 t\u1eadp trung v\u00e0o l\u00fd thuy\u1ebft m\u00e0 c\u00f2n cung c\u1ea5p nh\u1eefng v\u00ed d\u1ee5 th\u1ef1c ti\u1ec5n c\u1ee5 th\u1ec3, gi\u00fap ng\u01b0\u1eddi \u0111\u1ecdc hi\u1ec3u r\u00f5 c\u00e1ch \u00e1p d\u1ee5ng c\u00e1c nguy\u00ean t\u1eafc \u0111o l\u01b0\u1eddng v\u00e0o c\u1ea3i ti\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng y t\u1ebf. M\u1ed9t trong nh\u1eefng v\u00ed d\u1ee5 \u1ea5n t\u01b0\u1ee3ng l\u00e0 vi\u1ec7c c\u1ea3i thi\u1ec7n th\u1eddi gian \u201cdoor-to-needle\u201d trong \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9t qu\u1ef5. \u0110\u00e2y l\u00e0 m\u1ed9t ch\u1ec9 s\u1ed1 mang t\u00ednh s\u1ed1ng c\u00f2n, \u0111o l\u01b0\u1eddng th\u1eddi gian t\u1eeb khi b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n \u0111\u1ebfn khi \u0111\u01b0\u1ee3c ti\u00eam thu\u1ed1c tan m\u00e1u \u0111\u00f4ng. Vi\u1ec7c r\u00fat ng\u1eafn th\u1eddi gian n\u00e0y kh\u00f4ng ch\u1ec9 c\u1ee9u s\u1ed1ng nhi\u1ec1u b\u1ec7nh nh\u00e2n m\u00e0 c\u00f2n gi\u1ea3m chi ph\u00ed ch\u0103m s\u00f3c y t\u1ebf trong d\u00e0i h\u1ea1n.<\/p>\n\n\n\n<p>Tuy nhi\u00ean, kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111o l\u01b0\u1eddng \u0111\u1ec1u ho\u00e0n h\u1ea3o. T\u00e0i li\u1ec7u c\u0169ng ch\u1ec9 ra r\u1eb1ng m\u1ed9t s\u1ed1 ch\u1ec9 s\u1ed1 nh\u01b0 t\u1ef7 l\u1ec7 t\u1eed vong chu\u1ea9n h\u00f3a (HSMR) c\u00f3 th\u1ec3 g\u00e2y hi\u1ec3u l\u1ea7m n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh ph\u00f9 h\u1ee3p v\u1edbi y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a b\u1ec7nh nh\u00e2n. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y r\u1eb1ng, \u0111\u1ec3 \u0111o l\u01b0\u1eddng c\u00f3 gi\u00e1 tr\u1ecb, c\u1ea7n ph\u1ea3i x\u00e2y d\u1ef1ng c\u00e1c m\u00f4 h\u00ecnh \u0111i\u1ec1u ch\u1ec9nh ch\u00ednh x\u00e1c v\u00e0 c\u00f3 s\u1ef1 tham gia c\u1ee7a c\u00e1c chuy\u00ean gia trong t\u1eebng l\u0129nh v\u1ef1c.<\/p>\n\n\n\n<p><strong>4. \u0110o l\u01b0\u1eddng v\u00e0 t\u01b0\u01a1ng lai c\u1ee7a c\u1ea3i ti\u1ebfn y t\u1ebf<\/strong><\/p>\n\n\n\n<p>Nh\u00ecn chung, t\u00e0i li\u1ec7u \u0111\u00e3 tr\u00ecnh b\u00e0y m\u1ed9t c\u00e1ch \u0111\u1ea7y \u0111\u1ee7 v\u00e0 thuy\u1ebft ph\u1ee5c v\u1ec1 vai tr\u00f2 c\u1ee7a \u0111o l\u01b0\u1eddng trong c\u1ea3i ti\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng y t\u1ebf. N\u00f3 kh\u00f4ng ch\u1ec9 cung c\u1ea5p ki\u1ebfn th\u1ee9c n\u1ec1n t\u1ea3ng m\u00e0 c\u00f2n m\u1edf ra h\u01b0\u1edbng \u0111i m\u1edbi cho c\u00e1c nh\u00e0 qu\u1ea3n l\u00fd v\u00e0 chuy\u00ean gia y t\u1ebf trong vi\u1ec7c thi\u1ebft k\u1ebf c\u00e1c h\u1ec7 th\u1ed1ng \u0111o l\u01b0\u1eddng hi\u1ec7u qu\u1ea3 h\u01a1n.<\/p>\n\n\n\n<p>\u0110i\u1ec1u th\u00fa v\u1ecb l\u00e0, c\u00e1c nguy\u00ean t\u1eafc \u0111\u01b0\u1ee3c n\u00eau trong t\u00e0i li\u1ec7u kh\u00f4ng ch\u1ec9 gi\u1edbi h\u1ea1n trong y t\u1ebf m\u00e0 c\u00f2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong c\u00e1c ng\u00e0nh c\u00f4ng nghi\u1ec7p kh\u00e1c. Qu\u1ea3n l\u00fd ch\u1ea5t l\u01b0\u1ee3ng l\u00e0 m\u1ed9t b\u00e0i to\u00e1n to\u00e0n c\u1ea7u, v\u00e0 \u0111o l\u01b0\u1eddng lu\u00f4n l\u00e0 b\u01b0\u1edbc \u0111\u1ea7u ti\u00ean \u0111\u1ec3 gi\u1ea3i b\u00e0i to\u00e1n \u0111\u00f3. V\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00f4ng ngh\u1ec7 d\u1eef li\u1ec7u v\u00e0 tr\u00ed tu\u1ec7 nh\u00e2n t\u1ea1o, t\u01b0\u01a1ng lai c\u1ee7a \u0111o l\u01b0\u1eddng s\u1ebd kh\u00f4ng ch\u1ec9 d\u1eebng l\u1ea1i \u1edf vi\u1ec7c thu th\u1eadp th\u00f4ng tin m\u00e0 c\u00f2n ti\u1ebfn xa h\u01a1n trong vi\u1ec7c ph\u00e2n t\u00edch v\u00e0 d\u1ef1 \u0111o\u00e1n c\u00e1c xu h\u01b0\u1edbng ch\u1ea5t l\u01b0\u1ee3ng.<\/p>\n\n\n\n<p><strong>5. K\u1ebft lu\u1eadn<\/strong><\/p>\n\n\n\n<p>K\u1ebft l\u1ea1i, t\u00e0i li\u1ec7u \u201cMeasurement for Improvement\u201d \u0111\u00e3 l\u00e0m s\u00e1ng t\u1ecf vai tr\u00f2 kh\u00f4ng th\u1ec3 thi\u1ebfu c\u1ee7a \u0111o l\u01b0\u1eddng trong c\u1ea3i ti\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng y t\u1ebf, \u0111\u1ed3ng th\u1eddi \u0111\u1eb7t ra nh\u1eefng c\u00e2u h\u1ecfi quan tr\u1ecdng v\u1ec1 c\u00e1ch ti\u1ebfp c\u1eadn v\u00e0 tri\u1ec3n khai trong th\u1ef1c ti\u1ec5n. \u0110\u00e2y l\u00e0 m\u1ed9t ngu\u1ed3n t\u00e0i li\u1ec7u \u0111\u00e1ng gi\u00e1 cho b\u1ea5t k\u1ef3 ai quan t\u00e2m \u0111\u1ebfn l\u0129nh v\u1ef1c qu\u1ea3n l\u00fd ch\u1ea5t l\u01b0\u1ee3ng, kh\u00f4ng ch\u1ec9 trong y t\u1ebf m\u00e0 c\u00f2n trong m\u1ecdi h\u1ec7 th\u1ed1ng t\u1ed5 ch\u1ee9c.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-d88a6a02 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2025\/01\/22.jpg\" alt=\"\" class=\"uag-image-8191\" width=\"1432\" height=\"805\" title=\"22\" loading=\"lazy\" role=\"img\" \/><\/figure><\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>BS.CK2. L\u00ea H\u00e0 Xu\u00e2n S\u01a1n Tr\u01b0\u1edfng ph\u00f2ng Qu\u1ea3n l\u00fd ch\u1ea5t l\u01b0\u1ee3ng \u2013 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh T\u00e0i li\u1ec7u \u201cMeasurement for Improvement\u201d \u0111\u01b0a ra m\u1ed9t c\u00e1i nh\u00ecn to\u00e0n di\u1ec7n v\u00e0 s\u00e2u s\u1eafc v\u1ec1 vai tr\u00f2 c\u1ee7a \u0111o l\u01b0\u1eddng trong c\u1ea3i ti\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng y t\u1ebf, \u0111\u1eb7c bi\u1ec7t trong b\u1ed1i c\u1ea3nh hi\u1ec7n \u0111\u1ea1i khi c\u00e1c 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