改善家庭卫生中心的乙型肝炎查,使用质量改善和电子医疗记录工具
Jeannie S Huang1, Rusvelda Cruz1, Kathleen B Schwarz1
1From Rady Children's Hospital, University of California San Diego, La Jolla, CA.
Journal of pediatric gastroenterology and nutrition
|June 16, 2023
概括
改善美国难民的乙型肝炎查是至关重要的. 使用电子健康记录的质量改进方法成功提高了查率,并检测出了慢性乙型肝炎 (HBV) 感染的高率.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性乙型肝炎病毒 (HBV) 感染对全球健康造成重大负担,特别是在流行地区.
- 在美国,低于最佳的HBV查率需要针对高风险人群进行有针对性的干预.
- 难民群体通常来自HBV流行地区,增加了他们的易感性和查需求.
研究的目的:
- 在服务于高风险难民群体的家庭卫生中心,在两年内将HBV查率提高20%.
- 实施和评估在临床工作流程中集成的支持电子病历 (EMR) 的查工具的有效性.
- 改善在缺乏服务的难民社区中慢性HBV感染的识别和诊断.
主要方法:
- 使用质量改进 (QI) 方法来指导干预设计和实施.
- 集成的基于EMR的工具来捕获原产国数据并触发适当的HBV查订单.
- 在区域家庭健康中心进行了这项研究,以适应COVID-19大流行所带来的挑战.
主要成果:
- 实现了QI目标,显示了HBV查率的显著改善.
- 观察到四个统计过程控制图的转移,表明查性能持续的积极变化.
- 在接受查的人群中,HBV检测率高,从8.2%到12.8%不等.
结论:
- 支持EMR的工具有效地提高了高风险难民群体的HBV查率.
- 质量智能方法可以成功推动有针对性的公共卫生干预,即使在具有挑战性的环境中,如流行病.
- 高检测率强调了在难民卫生机构对HBV的系统查的重要性.
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