Collins P E, Skafel J R, Atkinson D I, Jenkins S
St. Thomas-Elgin General Hospital.
Healthc Manage Forum. 1994 Fall;7(3):27-40. doi: 10.1016/S0840-4704(10)61065-4.
The authors describe the CONTINUUM project which was initiated in a community hospital to manage the appropriateness, timeliness and acceptability of the patient care process on a concurrent or day-to-day basis. CONTINUUM is a quality and data-driven approach to continuous improvement of the patient care process. The St. Thomas-Elgin General Hospital researched "appropriateness of care" measurements and adapted their use for the CONTINUUM project. A concurrent care plan evaluation tool is applied to every care every day. This intensity of service (needs-based) strategy is called the ACTIVITY index. Patients are categorized ACTIV (appropriate) or non-ACTIV (perhaps inappropriate). Non-ACTIV patients are further subdivided into various "barriers to care," from which service, hospital or physician-related factors can be stratified. Practice patterns and hospital resource use are then rapidly identified. The operational dimensions of the project (bedside, organization and community) are described as well as the inhibitors and enablers of this change process.
作者介绍了CONTINUUM项目，该项目始于一家社区医院，旨在同步或日常管理患者护理过程的适宜性、及时性和可接受性。CONTINUUM是一种以质量和数据为驱动的方法，用于持续改进患者护理过程。圣托马斯 - 埃尔金综合医院研究了“护理适宜性”测量方法，并将其应用于CONTINUUM项目。每天都会对每项护理应用一个同步护理计划评估工具。这种基于需求的高强度服务策略被称为ACTIVITY指数。患者被分类为ACTIV（适宜）或非ACTIV（可能不适宜）。非ACTIV患者会进一步细分为各种“护理障碍”，从中可以区分出与服务、医院或医生相关的因素。然后迅速确定实践模式和医院资源使用情况。还描述了该项目的运营维度（床边、组织和社区）以及这一变革过程的阻碍因素和推动因素。
