A FOCUS-PDCA quality improvement model involving unlicensed assistive personnel for improving clinical effectiveness and efficiency in inpatient physical examination: a quasi-experimental, historical-control study

The accuracy and efficiency of inpatient examinations depend on a well-collaborated working team that involves doctors, nurses, and unlicensed assistive personnel (UAP). This study aimed to evaluate the clinical effectiveness and efficiency of a FOCUS-PDCA quality improvement model involving UAP in improving inpatient physical examinations. A quasi-experimental, historical-control before-and-after study was conducted among 372 patients who received the FOCUS-PDCA quality improvement examination management (the observation group) and another 385 patients under normal management (the control group). Clinical effectiveness and efficiency were compared between the two groups. Compared to the control group, the FOCUS-PDCA group had significantly lower rates of defect examinations (19.6% vs. 44.7%, p < 0.01), nursing interruption events (14.5% vs. 26.4%, p < 0.01), and nurse referral events (6.1% vs. 24.7%, p < 0.01). Furthermore, the FOCUS-PDCA group had higher patient satisfaction (9.04 ± 0.82 vs. 8.45 ± 0.96, p <0.01) lower hospital cost [Median: 29,434.70 RMB (IQR: 9,705.00–52,451.40) vs. 34,537.60 RMB (IQR: 14,689.98–64,222.12), p < 0.001], and shorter length of hospital stay [Median: 4.00 days (IQR: 3.00, 5.00) vs. 5.00 days (IQR: 4.00, 6.00), p < 0.001]. The FOCUS-PDCA model involving UAP was associated with improved clinical effectiveness and efficiency of inpatient physical examination, which may be applied in hospital management to enhance the quality of care and patient outcomes. Further validation in other clinical settings is needed to test its broader application.