一个以初级保健为基础的质量改善项目,以减少喘急诊室的访问
Stephen J Hersey1, Jessica Retzke1, Elizabeth D Allen2
1Division of Primary Care Pediatrics.
Pediatrics
|November 14, 2023
概括
一个质量改进项目在高风险的医疗补助人口中,为儿童喘减少了33%的急诊室访问. 这表明,在初级保健网络中,喘护理得到了可持续的改善.
科学领域:
- 提高儿科医疗保健质量 提高儿科医疗保健质量
- 公共卫生干预措施 公共卫生干预
- 喘管理的管理
背景情况:
- 喘恶化经常导致急诊室 (ED) 访问,特别是在医疗补助计划覆盖的儿童中.
- 2010年启动了一项质量改进项目,旨在在主要符合医疗补助计划的初级保健网络中加强儿科喘护理.
- 该项目旨在每年将2-18岁儿童与喘相关的ED访问量减少3%.
研究的目的:
- 为了减少与喘相关的急诊室 (ED) 在一个庞大,高风险的儿科人口中.
- 实施和维持儿童喘护理的多组件质量改进计划.
- 在初级保健环境中评估连续干预措施的有效性.
主要方法:
- 一个与儿童医院关联的多站点,城市,高风险的初级保健网络作为设置.
- 实施了五项连续的干预措施:增加了喘行动计划的使用,基于初级保健的喘专科诊所访问,标准化喘笔记,喘控制测试文档和及时的逐步治疗.
- 数据是从2010年到2019年收集的.
主要成果:
- 与喘相关的ED访问从每年每1000名患者中的21.7人减少到14.5人,减少33%.
- 该项目在5个关键干预措施中的4个实现并维持了目标指标.
- 在研究期间,ED使用率显著下降.
结论:
- 实施的质量改进项目成功地减少了大量高风险儿科患者中喘急诊室的使用率.
- 在初级保健网络中,通过多元组件的纵向方法,可以在喘护理中取得可持续的积极结果.
- 这些发现突出了质量改善举措影响弱势群体公共卫生结果的潜力.
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