术后质量改善的前景:使用现实世界的数据进行积极偏差的案例研究
Aaron B Low1, Jill R Maresh2, Terri Jarvi2
1Seattle Children's, Seattle, Washington, USA.
积极偏差 (PD) 通过关注成功而不是错误,提高了儿科医疗保健的程序效率. 这种方法增加了程序的数量和容量,而不会对质量措施产生负面影响.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 儿科卫生系统 儿科卫生系统
- 过程优化 过程优化
背景情况:
- 传统的质量和安全工作往往侧重于识别和修复错误,突出质量缺失.
- 积极偏差 (PD) 提供了一个替代方法,通过专注于传播成功的实践,而不是仅仅消除错误.
- 本研究探讨了PD在儿科医疗保健环境中的应用,以改善程序质量结果.
研究的目的:
- 描述和评估正偏差 (PD) 方法在改善儿科医疗保健系统程序质量结果方面的有效性.
- 展示如何专注于成功的实践可以提高效率和能力.
- 强调数据可访问性在促进最佳实践传播方面的作用.
主要方法:
- 使用连续质量改进方法与多学科团队评估和完善临床过程.
- 雇佣的AdaptX软件用于数据提取和分析,使用统计过程控制和道图来识别正偏差 (PD) 提供商.
- 实施了Plan-Do-Study-Act (PDSA) 循环,用于测试和完善新流程,以实时数据监控为指导.
主要成果:
- 通过减少手术准备时间,实现了每月手术量持续增加35%.
- 通过麻醉改进和额外的手术室,胃肠道学每月病例数增加了74%.
- 减少了麻醉后护理单位的持续时间,员工的加班时间,并通过提高按时表现来提高运营能力,而不会对平衡措施产生不利影响.
结论:
- 积极偏差 (PD) 方法有效地提高了儿科医疗保健的程序及时性和能力,而不会影响其他质量指标.
- 民主化,实时数据访问简化了最佳实践的识别和传播,从而带来了持续的改进.
- PD方法与临床医生的目标保持一致,促进参与和改善患者护理服务.
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