催化系统变革:1000天内完成100个质量改进项目
Amelia Sattler1, Anuradha Phadke2, Jake Mickelsen3
1Stanford University School of Medicine, Palo Alto, CA, USA. amelia2@stanford.edu.
Journal of general internal medicine
|November 20, 2023
概括
可扩展的质量改进 (QI) 培训使学术医疗中心的前线工作人员能够实施创新. 斯坦福大学的PC-PEP计划证明了可行性,并在不同的护理团队中提高了QI自我有效性.
科学领域:
- 医疗保健管理的管理
- 提高质量 提高科学 提高质量
- 初级保健创新初级保健的创新
背景情况:
- 有效的卫生系统变革需要强大的质量改进 (QI) 基础设施,以支持前线人员实施可持续创新.
- 斯坦福初级保健项目参与平台 (PC-PEP) 是为期8周的快速循环QI培训计划,专为面向患者的初级保健临床医生和工作人员设计.
研究的目的:
- 评估一个可扩展的QI计划的可行性和结果,该计划是为忙碌的实践提供者和学术医疗中心内的员工量身定制的.
- 评估PC-PEP计划对各种医疗保健团队的QI自我有效性和项目进展的影响.
主要方法:
- 斯坦福PC-PEP培训的项目评估.
- 来自斯坦福大学初级保健和人口健康 (PCPH) 诊所 (2018-2021) 的172名参与者 (提供者,员工,医学学习者) 参与了QI项目.
- 项目使用卫生保健改进研究所的五重目标 (QA) 进行分类,并使用修改后的创新框架跟踪进展;参与后测量了QI自我有效性.
主要成果:
- 172名参与者在1000天内完成了104个项目,主要侧重于改善患者健康 (55%) 和护理团队体验 (23%).
- 项目的进展有所不同,其中20%的项目扩展到不同的环境 (步骤5B);学习者参与与学术产品相关 (47%对10%).
- 98%的受访者报告QI自我效率有所改善,医疗助理对QI努力的认可更高 (100%vs医生61%).
结论:
- 可扩展的QI培训模型,如斯坦福PC-PEP,可以有效地赋予前线医疗保健工作者推动有意义的改进.
- 有了足够的QI基础设施,这些计划可以促进卫生保健改进研究所五重目标领域的进展.
- PC-PEP 计划展示了一种可行且具有影响力的方法,用于提高 QI 能力,并在初级保健机构中促进创新.
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