评估以患者为中心的外科护理质量,使用患者报告的共同决策措施
Jason B Liu1,2, Andrea L Pusic1,2, Larissa Kf Temple3,4
1Patient-Reported Outcomes, Value, and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA.
Journal of the American College of Surgeons
|April 8, 2025
概括
共享决策 (SDM) 可以在外科护理中进行测量. CollaboRATE工具可靠地区分了医院和外科医生级别的以患者为中心的护理质量,并提供了可行的样本大小来实施.
科学领域:
- 医疗保健的质量 医疗保健的质量
- 手术护理 手术护理
- 患者报告的结果
背景情况:
- 共享决策 (SDM) 在外科护理中至关重要,但缺乏患者视角的绩效指标.
- 从患者的角度评估SDM质量对于改善护理标准至关重要.
研究的目的:
- 评估SDM水平是否可以在医院和外科医生之间进行区分.
- 通过估计统计可靠性所需的样本大小来确定实施SDM作为绩效衡量的可行性.
主要方法:
- 使用了两种患者报告的SDM措施,即CollaboRATE和SDM-Q-9.
- 为医院和外科医生水平开发了24个候选人绩效指标.
- 混合模型分析了统计可靠性和预测的最小样本大小,探索风险调整和非响应偏差.
主要成果:
- 对于医院来说,CollaboRATE的可靠性更高 (中位数为0.81),需要192-235个反应.
- 在外科医生中,CollaboRATE的可靠性也更高 (中位数为0.49),只需要46个响应.
- 在医院和外科医生层面,SDM的性能差异是可以区分的.
结论:
- 在医院和外科医生层面,CollaboRATE可靠地区分了以患者为中心的护理质量.
- 由于响应次数要求较低,将CollaboRATE作为外科医生特定的绩效衡量标准是可行的.
- 这项研究支持使用患者报告的措施来评估手术环境中的SDM.
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