在国家多专业外科手术质量改进计划中,患者报告的结果措施
Larissa K F Temple1,2, Andrea L Pusic3,4,5, Jason B Liu3,5,6
1Surgical Health Outcomes and Research for Equity (SHORE) Center, Department of Surgery, University of Rochester Medical Center, Rochester, New York.
JAMA surgery
|June 26, 2024
概括
在国家手术质量改进计划中,通过电子方式实施患者报告结果措施 (PROM) 是可行的. 成功的关键策略包括优化健康信息技术 (HIT) 平台和建立患者信任.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 改善外科手术的质量
- 卫生信息技术 信息技术
背景情况:
- 患者报告结果措施 (PROM) 对于以患者为中心的护理至关重要,但在国家外科质量改进计划中面临挑战.
- 支持健康信息技术 (HIT) 的PROM实施需要进一步调查才能得到广泛采用.
研究的目的:
- 评估在国家手术质量改进计划中收集PROM的可行性.
- 确定提高PROM采集率的策略和影响患者反应的因素.
主要方法:
- 一项实用实施队列研究,涉及美国医院在美国外科医生学院国家外科质量改善计划.
- 利用医疗保健改进研究所 (IHI) 的扩散框架和实施研究的综合框架,通过计划-做-研究-行动 (PDSA) 周期运行.
- 后勤回归分析了与收集率和响应相关的医院和患者因素.
主要成果:
- 65家医院成功为超过13万名患者注射PROM,超过了30%的收集率目标.
- 通过多道通信 (电子邮件,短信),个性化消息和增加提醒,优化收集率.
- 患者的年龄和保险状况与不响应有关,而没有医院特征预测达到目标率.
结论:
- 大规模的电子PROM采集在国家外科注册处是可行的.
- 对HIT平台的功能和患者的信任对于成功实施至关重要.
- 需要持续努力来完善收集策略,并解决患者不响应问题,以持续改善质量.
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