[临床质量治理 - - 以流感疫苗接种为例的一般实践中的实用方法]
Vera Souhrada1, Mirjam Zrenner1, Emmily Schaubroeck2
1MVZ-Eckental, Universitätsklinikum Erlangen, Erlangen, Deutschland.
ZFA. Zeitschrift fur Allgemeinmedizin
|June 26, 2023
概括
临床质量治理 (CQG) 在与流行病相关的短缺期间改善了流感疫苗接种率. 一个系统的过程优先考虑高风险患者,将疫苗接种率从8%提高到74%.
科学领域:
- 医疗保健管理的管理
- 公共卫生政策 公共卫生政策
- 临床实践 临床实践
背景情况:
- 2020年流感疫苗接种需求升,可能是由于大流行,导致人们担心高风险人群的短缺问题.
- 临床质量治理 (CQG) 被定义为临床领域内的质量管理.
- 在卫生危机期间,资源稀缺性需要战略性分配.
研究的目的:
- 描述一个实例性的临床质量治理 (CQG) 流程,用于解决流感疫苗短缺问题.
- 激发讨论和采用CQG在临床环境中的资源配置策略.
- 提高高风险患者群体的疫苗接种覆盖率.
主要方法:
- 启动了三步的CQG过程: 1) 评估当前状态, 2) 优先考虑和接种疫苗的患者已经要求疫苗,和 3) 积极的外展和高风险的疫苗接种患者没有在最初的列表.
- 60岁以上的慢性阻塞性肺病 (COPD) 患者被确定为高优先级组.
- 在干预前后跟踪疫苗接种情况.
主要成果:
- 高风险慢性肺炎患者的初始流感疫苗接种覆盖率很低,为8% (3/38).
- 在优先考虑要求接种疫苗的患者后,覆盖率增加到66% (38分之25).
- 在与非名单上的高风险患者进行主动的电话联系后,整体疫苗接种覆盖率达到74% (共38名28名).
结论:
- 实施的CQG流程显著提高了高风险患者的流感疫苗接种覆盖率,接近世卫组织推的比例.
- CQG是管理资源稀缺并确保公平分配的有价值的策略,特别是在公共卫生紧急情况下.
- 电子患者记录系统的改进可以进一步加强针对疫苗接种运动的目标患者名单的生成.
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