实现快速的门到气球时间:顶级医院如何改善复杂的临床系统
Elizabeth H Bradley1, Leslie A Curry, Tashonna R Webster
1Division of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8088, USA.
医院改善ST升高急性心肌梗塞 (STEMI) 的门到气球时间,重点是明确的目标,领导支持,灵活的协议和数据反. 这些策略促进了性,并提高了临床性能.
科学领域:
- 心脏病学 心脏病学
- 医疗保健管理的管理
- 提高质量 提高质量
背景情况:
- 指南推的门到气球时间对于ST升高急性心肌梗塞 (STEMI) 治疗至关重要.
- 不到50%的STEMI患者达到这些关键时间目标.
- 了解成功的医院策略来改善STEMI护理是必不可少的.
研究的目的:
- 描述医院使用的方法,这些医院已经显著改善了门到气球的时间.
- 确定有助于成功提供STEMI护理的关键主题.
主要方法:
- 定性研究涉及122次与临床和行政人员的深入采访.
- 分析了11家医院,门到气球的平均时间≤90分钟 (2001-2002).
- 用于定性数据分析的常数比较方法.
主要成果:
- 8个关键主题出现了:明确的改进目标,高级管理层的支持,创新和灵活的协议,强大的临床领导力,协作团队,数据反和有弹性的组织文化.
- 对目标的承诺是由内部和外部压力驱动的.
- 改进标准化协议的灵活性对于适应至关重要.
结论:
- 成功改善门到气球时间的特点是多个相互关联的主题.
- 蒸这些经验为提高医院临床绩效提供了基础.
- 改善STEMI护理的组织变革需要多方面的方法.
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