使用多学科质量改进团队改善心脏康复推率
Cameron Whitler1, Kyle S Varkoly2, Harshil Patel1
1Department of Cardiovascular Medicine, Ascension Providence Hospital, Southfield, USA.
Cureus
|June 27, 2024
概括
实施质量改善计划显著增加了心脏康复转诊率,从51.2%增加到87.1%. 这种干预也成功地减少了缺血性心脏病患者转诊率的种族差异.
科学领域:
- 心脏病学 心脏病学
- 提高质量 提高质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心脏康复 (CR) 是患有缺血性心脏病的患者至关重要的,但尚未充分利用的资源.
- 尽管有IA类建议,但在许多医疗保健机构中,CR转诊率仍然不够理想.
研究的目的:
- 通过标准化订单流程,提高医院系统内的CR转诊率.
- 识别和解决导致低CR转介率的障碍.
主要方法:
- 一个多学科的质量改进团队采用了包括电子医疗记录 (EMR),提供者教育和医院协议在内的协作方法.
- 在EMR中自动化订单集,加上提供者对基于证据的医学教育,是关键干预措施.
- 一个QI委员会每月进行监测,跟踪EMR使用情况和推合规情况.
主要成果:
- 在12个月的时间里,CR转诊率从51.2%显著增加到87.1% (p = 0.0001).
- 这种改善在各种患者人口统计学方面是一致的,包括性别,种族和保险状况.
- 观察到种族差异显著减少,非洲裔美国患者的转诊率接近干预后高加索患者的转诊率.
结论:
- 有效的质量改进举措可以大幅提高CR推率.
- 通过EMR整合和教育标准化订单流程,可以帮助缩小CR转介的种族平等现有的差距.
- 需要进一步的多中心试验来确认可通用性.
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