参与结构化质量改进计划的障碍,以减少可避免的急诊室访问 - - 一项定性研究
Morgan K Penny1, C Ann Vitous2, Sarah E Bradley1
1Michigan Bariatric Surgery Collaborative, Ann Arbor, Michigan.
The Journal of surgical research
|June 18, 2024
概括
确定了减肥手术护理质量改善举措的障碍. 成功的项目需要特定地点的适应和资源,以减少可避免的急诊室访问.
科学领域:
- 医疗保健管理的管理
- 改善外科手术的质量
- 患者安全 患者安全
背景情况:
- 在多机构医院环境中,质量改进 (QI) 举措的研究不足.
- 在17家医院调查了影响QI计划的负面因素,特别是减少可避免的急诊室 (ED) 外科手术后的访问,调查了17家医院.
研究的目的:
- 探讨参与者对实施QI倡议实施减肥外科手术障碍的观点.
- 确定解释QI计划不有效实施或结果的主题.
主要方法:
- 使用半结构化小组采访对17个地点进行定性调查 (42次采访) 在全州范围的减肥QI计划中.
- 描述性内容分析,以识别QI计划实施的挑战,促进者和障碍.
- 使用MAXQDA软件进行的分析.
主要成果:
- 在医院中发现的障碍包括缺乏买入,提供者可访问性问题,资源不足和与患者相关的障碍.
- 倡议的有效性受到阻碍,因为它与ED访问的特定站点驱动因素 (例如,患者获得护理) 不一致.
- 针对现有医院系统的定制以及员工的参与 (员工,外科医生,领导) 对于成功至关重要.
结论:
- 这些发现可以指导未来的特定地点干预措施,以减少不必要的术后急救诊所访问.
- 一种细微的方法,适应设施的需求和资源,是有效的QI实施所必需的.
- 解决与买入,提供者访问,资源和患者护理相关的障碍,对于改善减肥手术结果至关重要.
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