虚拟质量改进培训计划的有效性,以改善大型卫生系统内的体重管理计划的覆盖范围
Laura J Damschroder1, Richard Evans1, H Myra Kim1,2
1VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
学习参与行动过程 (LEAP) 计划改善了退伍军人卫生管理局团队的质量改善参与. 与对照设施不同,LEAP设施保持了患者的接触,证明了其对学习卫生系统的有效性.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
- 医疗保健管理的管理
背景情况:
- 退伍军人卫生管理局 (VHA) 旨在通过持续质量改进 (QI) 提高医疗保健服务.
- 前线医疗中心团队需要有效的参与策略来推动QI计划.
- 学习健康系统依赖于强大的智商能力,以进行持续改进.
研究的目的:
- 评估LEAP (学习参与行动过程) 计划的有效性.
- 评估LEAP对吸引VHA前线团队参与QI活动的影响.
- 确定LEAP是否增强了学习卫生系统所必需的核心能力.
主要方法:
- 采用了一个分阶段差异差异研究设计.
- 在两年内,55个VHA设施被随机分配到8个集群的LEAP或对照组.
- 数据包括VHA电子健康记录,调查和教练现场笔记,分析MOVE! 项目招生和QI技能.
主要成果:
- 与对照组相比,LEAP设施在干预后的患者接触率下降的速度较慢.
- 高满意度率 (平均>4/5) 被LEAP参与者报告.
- 在LEAP后6个月 (p<0.05) 观察到自我报告的QI方法使用的显著增加.
结论:
- LEAP计划成功地使VHA团队参与了QI,这是学习卫生系统的关键组成部分.
- 在LEAP设施中,患者可持续接触,与控制设施的接触率下降形成鲜明对比.
- LEAP促进了基本的QI能力,表明其在VHA内改善医疗保健流程的价值.
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