使用可实现的医生反基准来提高质量改善:一个随机对照试验
C I Kiefe1, J J Allison, O D Williams
1University of Alabama at Birmingham, 1717 11th Ave S, MT 700, Birmingham, AL 35205-4785, USA. ckiefe@uab.edu
JAMA
|June 13, 2001
概括
在一项随机试验中,可实现的护理基准 (ABC) 显著改善了医生绩效反和患者护理质量. 这种质量改进干预措施在纳入医疗保健提供者的基准数据时表现出更高的有效性.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 医疗绩效测量方法 医疗绩效测量方法
- 临床实践管理的管理.
背景情况:
- 绩效反和基准测试对于改善医疗保健至关重要,但在随机试验中很少进行评估.
- 可实现的护理基准 (ABC) 代表从同行绩效数据中获得的可实现的卓越标准.
- 从现有的性能数据中轻松计算ABC,为质量评估提供可重复的方法.
研究的目的:
- 评估使用可实现的基准来增强标准医生绩效反的影响.
- 确定可实现的基准是否可以导致患者护理的可衡量的改善.
主要方法:
- 1996年12月至1998年进行了一项随机对照试验.
- 70名社区医生和2978名患有糖尿病的医疗保险患者参加了这项研究.
- 医生收到标准反或反,并增加了可实现的基准数据.
主要成果:
- 与对照组 (40%至46%) 相比,实验组的流感疫苗接种率 (40%至58%) 显著改善.
- 可实现的基准医生提供适当护理的几率更高,包括足部检查和血糖控制监测.
- 在调整医生特征后,该干预表明对胆固醇和甘油三监测具有统计学意义的积极影响.
结论:
- 整合可实现的基准值大大提高了医生绩效反的有效性.
- 这种方法为改善临床环境中的护理质量提供了有价值的策略.
- 可实现的基准提供了一种数据驱动的方法,以推动医疗保健的有意义的质量改善.
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