行动中的公平:在质量改善中嵌入公平的范围审查和元框架
Tara A Burra1,2,3, Bourne Auguste4,5,6, Lisha Lo4
1Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada tara.burra@camh.ca.
BMJ quality & safety
|March 13, 2025
概括
一个新的元框架指导质量改进 (QI) 领导者嵌入健康公平. 这一框架与有实践经验的人共同设计,涉及组织文化,并提供可采取行动的领域,以减少医疗保健不平等.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 健康 公平 研究 健康 公平 研究
- 健康差异 在健康上的差异
背景情况:
- 越来越多地强调将健康公平纳入质量改进 (QI) 计划.
- 缺乏全面的框架阻碍了QI社区减少医疗保健不平等的努力.
研究的目的:
- 为QI绘制和总结现有的股权框架.
- 为QI从业者开发一个"元框架",结合从事健康不平等生活经验的人的见解.
主要方法:
- 对四个主要数据库 (MEDLINE,Embase,PsycInfo,CINAHL) 和参考列表进行范围审查.
- 包括详细介绍股权融入QI的文章.
- 定性诱导主题分析与社区成员参与和咨询相结合.
主要成果:
- 开发了一个元框架,包括两个支持因素 (理论基础,组织文化/领导力) 和六个领域.
- 六个领域包括吸引生活经验,定义股权问题,多样化QI团队,检查根本原因,干预减少不平等,衡量股权影响.
- 社区咨询突出了促进者和陷,让社区成员参与QI.
结论:
- 开发的元框架提供了一个全面的资源,用于将公平整合到所有QA实践中.
- 建议对该框架的实施进行进一步的研究.
- 对QI指导方针和培训的修订是必要的,以维持在QI中公平的整合.
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