实施医疗团队培训计划与外科手术死亡率之间的关联
Julia Neily1, Peter D Mills, Yinong Young-Xu
1National Center for Patient Safety, Department of Veterans Affairs, Hanover, New Hampshire, USA. Julia.Neily@va.gov
JAMA
|October 21, 2010
概括
退伍军人健康管理局的退伍军人健康管理局.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 医疗团队培训 医疗团队培训
背景情况:
- 关于医疗团队培训对外科手术结果的影响的数据有限.
- 退伍军人卫生管理局 (VHA) 实施了一项国家手术室人员培训计划.
研究的目的:
- 调查VHA医疗团队培训计划与手术结果之间的关联.
- 评估该计划对VHA设施内的死亡率的影响.
主要方法:
- 追溯性医疗服务研究,使用同期对照组.
- 分析了来自108个VHA设施的182,409个程序 (2006-2008财年).
- VHA培训包括简报,解答,检查清单和季度指导.
主要成果:
- 培训计划中的设施显示,每年死亡率下降了18%.
- 在训练组中,风险调整后的死亡率明显下降 (约为1. 50%更大的减少).
- 观察到一种剂量-反应关系:每个训练季度与每1000次手术减少0.5例死亡相关.
结论:
- 参与VHA医疗团队培训计划与手术死亡率的降低有关.
- 这些发现支持正式团队培训在提高手术患者安全方面的有效性.
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