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改善科学提高了一般儿科心脏病的常规脂质查
Jonathan N Flyer1, Elizabeth Congdon2, Scott B Yeager1
1Department of Pediatrics, The Robert Larner M.D. College of Medicine at the University of Vermont, Burlington, VT; Division of Pediatric Cardiology, The University of Vermont Children's Hospital, Burlington, VT.
患者教育,医生咨询和护理点 (POC) 测试显著改善了儿童心脏病学国家脂质查指南的遵守. 这种方法为初级保健实践提供了一个可扩展的模型.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 公共卫生 公共卫生
背景情况:
- 遵守国家脂质查指南对于儿科心血管健康至关重要.
- 目前在一般儿科心脏病实践中的查率往往不符合指导方针.
- 确定有效的干预措施来改善脂质查是公共卫生的优先事项.
研究的目的:
- 评估患者教育,医生咨询和护理点 (POC) 测试对脂质查遵守的影响.
- 在一般儿科心脏病实践环境中评估这些干预措施.
- 确定在初级保健中实施这些策略的可行性.
主要方法:
- 一项对区域初级保健提供者的调查确定了查的关键驱动因素.
- 干预措施包括患者教育材料,医生咨询和系统重新设计.
- 系统的重新设计包括教育海报,EHR集成和POC测试.
- 使用运行图表和统计过程控制图表来监测选率.
主要成果:
- 在儿科心脏病学中,基线脂质查率为0%,仅通过教育就增加到7%.
- 包括POC测试在内的系统重新设计使选率提高到61%.
- 在91.7%的查中使用POC测试,在检测脂质异常方面没有区别,而在查方面则没有区别.
结论:
- 结合患者教育,医生咨询和POC测试的多方面的方法显著提高了对脂质查指南的遵守.
- 实施的策略表明了改善初级保健机构脂质查的潜在模式.
- 临床检测促进了更高的查率和有效检测脂质异常.
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