通过标准化,结构化的点对点反和建立改进能力和文化来改善部门的质量改进计划
Hailey Hobbs1, Samantha Calder-Sprackman2, Amelia Wilkinson3
1Department of Critical Care Medicine, McMaster University, Hamilton, Ontario, Canada.
BMJ open quality
|November 17, 2025
概括
医生主导的质量改进举措显著提高了临床部门质量改进计划 (QIP) 的质量和一致性. 这些干预措施提高了医生对质量改进 (QI) 方法的了解,并使部门专注于QI优先事项.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 医学教育 医学教育
- 卫生系统管理管理卫生系统管理
背景情况:
- 质量改进计划 (QIP) 对于提高医疗保健质量和集中改进工作至关重要.
- 之前的努力注意到临床部门的QIP质量和内容的异质性.
- 一个由医生领导的质量委员会旨在标准化QIP,并使部门优先事项与全医院质量改善 (QI) 目标保持一致.
研究的目的:
- 提高临床部门QIP的质量和内容.
- 增加部门和全医院的QI优先事项之间的协调.
- 评估医生主导干预措施对QIP质量和医生对QI的理解的影响.
主要方法:
- 医师质量委员会在学术三级医院实施多方面的干预.
- 干预措施包括同行反,纵向教育,标准化模板和文化变革促进.
- 来自13个部门的QIP被评分使用前 (2018-2019) 和后 (2022-2023) 干预的标签;医生QI领导完成了感知调查.
主要成果:
- 平均QIP分数显著增加,从4.4/12 (2018-2019) 增加到8.0/12 (2022-2023) (p=0.0005).
- 平均得分从4.5 (IQR3.5-5.13) 增加到8.5 (IQR7.0-9.0). 平均得分从4.5 (IQR3.5-5.13) 增加到8.5 (IQR7.0-9.0) 增加到8.5 (IQR7.0-9.0). 平均得分从4.5 (IQR3.5-5.13) 增加到8.5 (IQR7.0-9.0) 增加到8.5 (IQR7.0-9.0).
- 医生QI领导报告高满意度与QI项目结构 (4.4/5) 和部门QI重点 (3.9/5).
结论:
- 医生主导的干预措施有效地提高了临床部门QIP的质量和内容.
- 这些倡议提高了医生对QI方法的了解,并提高了对部门QI优先事项的关注.
- 该计划成功地提高了对全医院改进工作的认识,并促进了更好的协调.
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