摘要目的:准确有效识别重症心肺疾病患者体外膜肺氧合（ECMO）救治的最关键需求，以更好地进行医疗服务质量持续改进活动，提升患者满意度。方法:选择河南省人民医院重症医学专科联盟内56家医疗机构行ECMO转运的患者〔2017年6月至2018年5月应用质量功能展开（QFD）前转运的患者为对照组，2018年6月至2019年5月应用QFD后转运的患者为观察组〕、联盟医院医务人员、ECMO转运团队、转运司机团队作为调查对象进行问卷调查，应用QFD工具，将收集到的需求转换成质量改进要素，以获取针对性改进措施。结果:本次调查共发放问卷125份，回收有效问卷116份，其中患者91份（包括对照组27份、观察组64份）、联盟医院医务人员10份、ECMO转运团队10份、转运司机团队5份，问卷回收率92.8%。重症心肺疾病患者ECMO救治改进要素按照重要度进行排序，其中前5位依次为首诊评估精准化、ECMO团队专职化、车辆安全有保障、响应对接无缝隙、协同救治流程畅。结论:联盟各医院对重症心肺疾病患者进行ECMO救治中应优先考虑上述5个改进要素，以确保患者得到更准确、及时的救治。

abstractsObjective:To accurately and effectively identify the most critical needs of extracorporeal membrane oxygenation (ECMO) treatment for patients with severe cardiopulmonary diseases, and to better carry out continuous improvement of medical service quality an patients' satisfaction.Methods:Patients who underwent ECMO and transferred from 56 medical institutions in the Henan Provincial People's Hospital Critical Care Medicine Specialist Alliance [the patients who were transported before applying quality function deployment (QFD) from June 2017 to May 2018 were enrolled as the control group, and patients who were transported after applying QFD from June 2018 to May 2019 were the observation group], medical staff in the alliance hospitals, ECMO transfer teams and transfer driver teams were enrolled as the subjects of the survey. QFD was applied to convert the collected requirements into quality improvement elements for targeted improvement measures.Results:A total of 125 questionnaires were distributed in this survey, and 116 valid questionnaires were collected, including 91 from patients (including 27 from the control group and 64 from the observation group), 10 from the medical staff of the alliance hospitals, 10 from the ECMO transport teams and 5 from the transport driver teams. The questionnaire recovery rate was 92.8%. The improvement elements of ECMO treatment for patients with critical cardiopulmonary diseases were ranked according to the importance, and the top five were as follows: the accuracy of the first diagnosis, the specialization of ECMO team, the guarantee of vehicle safety, the seamless responses, and the smooth coordinated rescue protocol.Conclusion:The top five improvement elements should be prioritized in ECMO treatment of patients with critical cardiopulmonary disease in all hospitals of the Alliance to ensure more accurate and timely treatment.