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护理质量的下一个前沿:解决已知的差距,改变护理交付
Mallika L Mendu1, Wingel Xue2, Lipika Samal3
1Nephrology Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Advances in kidney disease and health
|February 10, 2025
概括
目前的病质量指标集中在透析上,但未来的计划必须优先考虑以患者为中心,结果和在所有护理阶段的公平性,以实现真正的质量改善.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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:
- 过去十年,对病的质量测量集中在末期病 (ESRD) 和透析护理上.
- 像ESRD质量激励计划和基于价值的护理模式 (ESRD治疗选择,脏护理选择) 等倡议主要针对透析单位.
- 现有的质量指标在有效性,归因和风险调整方面面临挑战,对改善护理的影响受到质疑.
研究的目的:
- 倡导对脏护理质量测量和改善策略的转变.
- 突出需要一个更全面和以患者为中心的方法来提高病护理的质量.
主要方法:
- 审查和批评病现有的质量测量框架.
- 分析当前的绩效支付和基于价值的护理模式的局限性.
- 为未来的质量改进举措制定概念框架.
主要成果:
- 目前的质量指标通常范围有限,重点关注透析护理.
- 现有的激励模式在推动有意义的护理改进方面显示出可疑的有效性.
- 确定的挑战包括措施有效性,归因和风险调整.
结论:
- 脏护理质量发展的下一阶段必须整合以患者为中心,临床结果和健康公平.
- 质量倡议需要涵盖病治疗的整个连续性,而不仅仅是透析.
- 解决差异和打破护理孤岛对于改变脏护理质量至关重要.
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