制定针对手术中低价值护理的国际质量措施
Emily A Schultz1, Robin N Kamal1,
1VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
国际手术外科医生制定了质量措施,以减少手术中低价值的护理,解决全球不必要的成本和潜在的伤害. 这五项经过验证的措施旨在改善全球的患者结果和医疗保健效率.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 低价值的护理,以缺乏益处,增加伤害风险或不必要的成本为特征,在全球手和上肢手术中普遍存在.
- 目前的质量指标不足以在全球范围内评估低价值护理.
研究的目的:
- 开发重要的,可行的,可用的,科学可接受的手术国际质量标准.
- 在全球范围内减少手和上肢手术的低价值护理.
主要方法:
- 一项文献审查确定了手术中低价值护理的潜在领域.
- 采用了经过修改的Delphi适当性过程,涉及美国和国际手术手术师小组.
- 十个候选质量措施被评估为重要性,可行性,可用性和科学可接受性.
主要成果:
- 十个候选质量指标中的五个达到了共识,并被美国和国际专家组认为是有效的.
- 已验证的措施重点是尽量减少第五手臂部骨折的不必要固定,偏远半径骨折的伤后成像,外科手术期间的抗生素,手术前的测试和阿片类药物的使用.
- 两项措施的有效性均存在差异,只有美国和只有国际验证.
结论:
- 在国际质量措施组合上达成共识,以减少手术中低价值护理.
- 这些质量指标适用于各种全球医疗保健系统.
- 实施这些措施可能会减轻与低价值护理相关的风险,并改善全球的外科手术实践.
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