PDCA Cycle Intervention Improves Critical Value Management Rate in Primary Healthcare Institutions
A prospective, multicenter cohort study using interrupted time series analysis evaluated a 24-month PDCA (Plan-Do-Check-Act) cycle intervention in 62 primary healthcare institutions in Jiangsu Province. The intervention included implementing a unified Critical Value Reporting Protocol, standardizing logbooks, and establishing monitoring mechanisms. The comparator was the pre-intervention period, analyzed via time series methods.
The primary outcome was the standardized critical value management rate. Following the intervention, this rate increased from a pre-intervention average of 93.8% to 98.9%. The interrupted time series analysis reported an odds ratio (OR) of 1.721 for immediate improvement (p=0.012) and an OR of 1.298 for the trend effect (p<0.001), indicating both a significant step-change and a sustained positive trend post-intervention.
Safety and tolerability data were not reported. The study's key limitation is its observational design; while interrupted time series helps distinguish intervention effects from underlying trends, it cannot establish causality with the same certainty as a randomized trial. The authors note the model offers operational practicality and scalability for quality improvement. The findings suggest a structured PDCA approach may enhance process adherence in primary care settings, but broader implementation should be guided by local context and further evidence.