利用质量和安全持续流程改进框架,以增加乳腺癌查的准入
Pragya Dhar1, Heather Johnston2, Nita Amornsiripanitch3
1Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
Journal of the American College of Radiology : JACR
|October 30, 2025
概括
一个数字提醒程序简单地减少了查乳房扫描,错过了护理机会. 然而,短信提醒增加了错过的护理,而数字参与减少了它,突出了放射学接入的数字沟.
科学领域:
- 放射学和成像学 放射学和成像学
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
背景情况:
- 查乳房学错过护理机会 (SM-MCO) 率仍然是确保及时检测癌症的挑战.
- 数字健康干预提供了潜在的解决方案,以改善患者遵守查预约.
- 质量改进 (QI) 框架为开发和完善医疗保健流程提供了结构化的方法.
研究的目的:
- 使用质量和安全持续流程改进方法实施和评估数字提醒程序.
- 评估计划-做-研究-采取行动 (PDSA) 周期对查乳房图像错过护理机会 (SM-MCO) 率的影响.
- 分析数字参与和特定干预措施 (如短信提醒和教育视频) 对中小企业和中小企业的利率的影响.
主要方法:
- 在两个联邦资格社区卫生中心和一个移动乳房镜片单位进行了质量改进研究.
- 该研究采用了Plan-Do-Study-Act (PDSA) 周期,包括实施多语言短消息系统 (SMS) 和教育视频.
- 使用统计过程控制 (SPC) p图表和回归分析来评估SM-MCO率和数字参与度.
主要成果:
- 整体SM-MCO率从干预前的29.2%下降到干预后的26.9% (P < .001).
- 收到SMS提醒的预约会有较高的SM-MCO率 (35%) 与没有 (21.7%) 相比.
- 数字参与与较低的SM-MCO率 (21.7%vs. 40.4%) 相关,观看教育视频进一步将这一率降至11.5%.
结论:
- 虽然数字提醒程序显示了SM-MCOs的整体适度减少,但SMS提醒有悖论地增加了错过的护理.
- 数字参与和教育视频观看显著降低了SM-MCO率,这表明它们的有效性.
- 质量智能框架对于代改进数字策略至关重要,以弥合数字沟并加强对放射学服务的访问.
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