Enhancing Medical Record Quality in Psychiatric Care Through PDCA Cycle Management

Objective: To evaluate the effect of Plan-Do-Check-Act (PDCA) cycle management on psychiatric medical record quality. Methods: This pre-post intervention study implemented PDCA from February 2023. A time-series analysis compared monthly Class A record rates (≥ 90% on a standardized checklist) across 12 months post-implementation (Feb 2023–Jan 2024). Using stratified random sampling by department, 150 records per group were selected: pre-intervention control (before 2023), observation group 1 (Feb 2023–Jan 2024, comprehensive review), and observation group 2 (Jan–Dec 2025, spot-check review). Fourteen ward physicians rated satisfaction pre- and post-intervention. Possible confounders (department, time) were addressed via stratified sampling and time-series segmentation. Statistical analyses included ANOVA with effect sizes (η 2 ) for group comparisons and paired t -test with Cohen’s d for satisfaction scores. Results: After implementation of the PDCA cycle, the monthly Class A record rate remained above 90% (range: 94.49– 98.48%). Statistically significant between‑month differences were observed at several time points (eg, April and September 2023, both p< 0.01). One‑way ANOVA indicated a statistically significant difference among the three groups (F=57.59, p < 0.01, η 2 =0.205). Quality scores were higher in both observation groups compared with the control group (observation group 1: 95.01± 2.44 vs control: 92.26± 3.58; observation group 2: 95.29± 1.79 vs control: 92.26± 3.58; both p < 0.01), whereas no significant difference was found between the two observation groups ( p > 0.05). Physician satisfaction scores also showed a statistically significant increase (97.29± 2.09 vs 85.14± 4.35; t = − 12.02, p < 0.01, Cohen’s d = − 3.213). In the present study, the Class A rate was maintained above 90% and physician satisfaction was higher after PDCA implementation. Conclusion: In this single‑center pre‑post study, implementation of the PDCA cycle was associated with improvements in medical record quality and physician satisfaction. Further research is needed to confirm these findings in other settings.