系统改进的外展模拟:一种新的宣传和报告过程
A St-Onge-St-Hilaire1, B Lawton1,2, L Dodson1
1Simulation Training Optimising Resuscitation for Kids (STORK) Statewide Simulation Service, Queensland Children's Hospital, South Brisbane, QLD, Australia.
通过专注于可测量的系统层面变化而不是直接的患者结果, 医疗模拟计划可以有效地改善系统. 这种方法确保了教育举措的问责制和可行性.
科学领域:
- 医疗保健教育
- 系统改进
- 质量管理
背景情况:
- 测量医疗模拟计划对患者的直接结果往往是不可行的,而且资源密集.
- 现有的问责措施可能与模拟服务的实用性不一致.
- 建议转向测量系统层面的影响,以便进行可靠和可实现的评估.
研究的目的:
- 评估模拟计划对医疗保健系统的影响,而不是个别患者的结果.
- 实施和评估一种以模拟为导向的质量改进的新测量过程.
- 通过模拟确定系统层面问题的可行解决方案.
主要方法:
- 将翻译模拟和质量改进方法整合到一个教育课程中.
- 使用模拟来诊断昆士兰州设施中的工作场所环境和系统级问题.
- 采用了新的电子报告系统 (Optimus PRIME课程摘要) 和后续审计,以追踪问题解决和资源使用情况.
主要成果:
- 在37个设施中发现了242个问题, 主要是药物安全和设备管理.
- 已确定问题的解决率为45.5%,其中44.6%仍在进行中.
- 在64%的医疗机构成功实施推资源.
结论:
- 通过模拟专注于系统层面的改进为改善医疗保健系统提供了重要途径.
- 开发的报告框架为评估模拟影响提供了可靠,可行和协同作用的方法.
- 学习的经验可以指导其他模拟服务在改进其测量策略以提高效率.
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