Fontana T A, Butcher S, O'Brien S A
George Washington University Medical Center, Washington, DC.
Qual Lett Healthc Lead. 1994 Jul-Aug;6(6):31-9.
Despite the time and resources that The George Washington University Medical Center (GWUMC) put into training and forming QI teams, QI staff found that CQI was not being used to carry out critical day-to-day departmental functions. In other words, CQI didn't affect the way staff did "real work." In response, the medical center developed an approach that integrates CQI with departmental leadership, structure, culture, and work routine. With the help of a coach, willing departments at GWUMC choose from a series of 155 activities that they complete at their own pace (eg, setting departmental CQI goals, developing a departmental mission). The department deployment process moves staff through three levels of increasing sophistication and maturity with CQI methods: awareness, understanding, and bonding. It is intended to make quality a habit for staff, or a part of the organizational mind set, rather than an isolated "project." This article will describe how the department deployment approach was developed, its philosophical underpinnings, and its methodology and tools. Then, an example will illustrate how one hospital department--social work and utilization case management--successfully used this approach.
尽管乔治华盛顿大学医学中心（GWUMC）投入了时间和资源来培训和组建质量改进团队，但质量改进工作人员发现，持续质量改进（CQI）并未被用于执行关键的日常部门职能。换句话说，CQI并没有影响员工开展“实际工作”的方式。作为回应，该医学中心开发了一种将CQI与部门领导、结构、文化和工作流程相结合的方法。在一名教练的帮助下，GWUMC中愿意参与的部门从一系列155项活动中进行选择，并按照自己的节奏完成这些活动（例如，设定部门CQI目标、制定部门使命）。部门部署过程使员工在CQI方法方面经历三个层次的提升，即从认知到理解再到融合。其目的是让质量成为员工的一种习惯，或者成为组织思维模式的一部分，而不是一个孤立的“项目”。本文将描述部门部署方法是如何开发的、其理论基础、方法和工具。然后，将通过一个例子来说明一个医院科室——社会工作与利用情况案例管理——是如何成功使用这种方法的。
