Chinese Journal of Blood Purification ›› 2023, Vol. 22 ›› Issue (1): 73-78.doi: 10.3969/j.issn.1671-4091.2023.01.017

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Establishment and clinical practice of quantitative scoring strategy for hemodialysis quality control and improvement management in Beijing

ZHANG Yue, DIAO Zong-li, GUO Wang, WEI Tao, LIU Wen-hu   

  1. Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; 2Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China; 3Beijing Blood Purification Quality Control and Improvement Center, Beijing 100050, China; 4Faculty of Nephrology, Capital Medical University, Beijing 100050, China
  • Received:2022-09-15 Revised:2022-10-20 Online:2023-01-12 Published:2023-01-12
  • Contact: 100050 北京, 1首都医科大学附属北京友谊医院肾内科血液净化中心 E-mail:liuwh0211@emzu.com.cn

Abstract: Objectives  To establish a practical method to improve compliance of the academic guidelines in dialysis units in Beijing.  Methods  Quantitative scoring strategy was built up based on the practicable clinical parameters and the guidelines from other countries. The rate of compliance with the guidelines and the rate of guideline performance during the period from 2014 to 2020 were calculated using the data from the database in Beijing Blood Purification Quality Control and Improvement Center. The dialysis units were then ranked according to the total scores of compliance rate and guideline performance rate.  Results  Eight clinical parameters were incorporated in the quantitative scoring strategy: hemoglobin, serum albumin, ferritin, calcium, phosphorus, iPTH, URR, and Kt/V. After implementation of the strategy for 5 years, the compliance and performance rates for hemoglobin (from 58.7% to 79.7%, χ2=18.339, P=0.005), serum albumin (from 82.2% to 85.6%,  χ2=0.253, P=0.615), ferritin (from 47.5% to 63.4%,  χ2=8.935, P=0.003), calcium ( χ2=5.113, P=0.024), phosphorus (from 41.7% to 47.6%),  and iPTH (from 28.2% to 35.3%,  χ2=2.037, P=0.153) increased steadily, but URR and Kt/V were slightly reduced in spite of their appropriate guideline performance.  Conclusions  The quantitative scoring strategy is a simple and practicable tool for administration and management of blood purification quality control and improvement.

Key words:  Hemodialysis, Quality control, Clinical practice, Quantitative scoring

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