A proposed hybrid root cause analysis technique for medical quality control of gynecological endoscopy–a cross-sectional study on China

Objective: To find out the key factors affecting the medical quality of gynecological endoscopy, and clarify the characteristics and intensity of the factors. To explore the feasibility of the application of new analytical tools in medical quality control. Methods: This cross-sectional study was conducted in the eighth Session of The Quality Control Committee of Gynecological Endoscopy of Fujian Province, China in January 2022. Twenty-three gynecological endoscopy quality control experts who attended the conference filled in the questionnaire on site. Using the new analysis model constructed by total interpretative structure model (TISM) and cause and effect diagram (CED), 20 potential factors of gynecological endoscopy medical quality were analyzed to find the core factors affecting medical quality. Result: Among the 20 potential factors affecting the medical quality of gynecological endoscopy, 9 factors with strong influence were screened out. Lack of quality control personnel, lack of regular personnel assessment and training, insufficient support of relevant departments and lack of beds are the high-level driving factors affecting the medical quality of gynecological endoscopy. Inadequate management of surgical grading, improper authorization of operation, insufficient personnel experience and insufficient hospital quality control supervision are the factors of medium-level connection. The high-level driving factors have the most significant impact on medical quality, which needs to be paid more attention, followed by the medium-level connecting factors. Conclusion: The TISM-CED model is an effective tool to trace the core factors and clarify the characteristics and order of factors, which can be applied to medical quality control.