对于卫生系统结直肠癌查服务的"泥审计"
Michelle S Rockwell1, Mary C Frazier, Jeffrey S Stein
1Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, 1 Riverside Circle, Ste 102, Roanoke, VA 24016.
医疗保健的"泥"大大阻碍了结直肠癌 (CRC) 查的完成. 一项试点研究确定了沟通,时间和行政负担是负面影响CRC查率和公平性的关键因素.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 胃肠病学 胃肠病学
背景情况:
- "污泥",定义为医疗保健系统的摩擦,是一个未经研究的因素,可能限制结肠直肠癌 (CRC) 查.
- 了解和量化污泥对于改善CRC查和患者结果至关重要.
研究的目的:
- 在卫生系统的CRC查过程中试行一种混合方法方法来识别和量化污泥.
- 评估污泥对CRC选率,效率和公平性的影响.
主要方法:
- 进行了混合方法的污泥审计,整合了定量数据 (索赔,电子记录,行政档案) 和定性数据 (采访,观察).
- 分析的重点是确定污泥的实例,并评估低价值的CRC选过程.
- 收集和分析了数据,以确定CRC查交付中的特定摩擦区域.
主要成果:
- 审计发现CRC选中存在重大污泥,选率为60.4%,其中一半的选订单未完成.
- 确定的污泥类别包括通信,时间,技术,行政任务,文书工作和低价值的护理,等待时间长,订单重复.
- 完成的查 (32%) 和相关的手术前检测 (38%) 的显著比例是低价值的,不成比例地影响弱势患者.
结论:
- 开发的污泥审计方法有效地识别和量化了卫生系统CRC查途径中的许多障碍.
- 污泥审计为组织提供了一种系统的方法来评估和减轻障碍,从而提高CRC选的有效性和公平性.
- 减少污泥对于优化CRC查和改善人口健康结果至关重要.
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