一个由实习生领导的质量改进项目,利用变革管理理论改进床边圆形化
Kim Tran Lopez1,2, Katherine Pumphrey1,2, Jessica Hart1,2
1Section of Hospital Medicine, Division of General Pediatrics, Department of Pediatrics.
Hospital pediatrics
|October 16, 2023
概括
一个由实习生领导的质量改进计划成功地增加了儿科护理的病床周,增强了以患者为中心的沟通. 这种方法将变革管理理论与实际干预相结合,导致以家庭为中心的护理实践得到持续改进.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 儿科患者护理 儿科患者护理
- 医学中的变革管理
背景情况:
- 随着COVID-19的流行,医疗机构的以家庭为中心的轮次大大受到干扰.
- 在大流行后的一般儿科住院小组中,观察到病床周的显着减少.
- 较低的床边圆形化率会影响患者的沟通和家庭参与儿科护理.
研究的目的:
- 实施一个由实习生领导的倡议,以增加一般儿科团队的病床巡回.
- 在最初的团队中,在6个月内,将床边轮回的比例从18%提高到50%.
- 在实施6个月内,将所有一般儿科团队的改善扩大到50%.
主要方法:
- 利用改进模型框架确定关键驱动因素:知识,文化和物流.
- 实施了12个计划-做-研究-行动 (PDSA) 周期来测试和完善干预措施.
- 测量了床边轮回的百分比 (初级),护理人员出席 (二级) 和护士出席/圆形时间 (平衡).
主要成果:
- 对于最初的团队来说,每周的床上轮次从18%增加到89%,持续了12个月.
- 在所有一般儿科团队中,在项目扩展后,床边圆形化从7%增加到54%.
- 显著的改进与通信捆绑 (PDSA周期2) 和项目扩展 (PDSA周期5) 有关.
结论:
- 一个由实习生领导的倡议有效地将变革管理理论与质量改进相结合.
- 这种方法导致了儿科护理的病床周的快速和可持续增加.
- 这个模型展示了一个成功的策略,以加强以家庭为中心的护理实践.
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