Wallace R G, Farmer R M, Craig A S, Kiefe C
Alabama Quality Assurance Foundation, Inc., Birmingham 35243, USA.
Clin Perform Qual Health Care. 1996 Jan-Mar;4(1):34-7.
The overall success of any continuous quality improvement (CQI) project lies in the ability to measure changes resulting from the project and to show that changes have resulted n improved care.
A software tool was developed to categorize hospital responses and activities implemented by hospitals as a result of the Cooperative Cardiovascular Project CCP). Information was captured regarding the hospital's acceptance of data and the educational/interventional strategies implemented. Hospital size, number of acute myocardial infarction patients treated, indicator performances, and type of presentation given (on-site versus regional visit) was entered to allow analysis of factors affecting the response.
sixty-one of 107 hospitals responded to the peer review organization. Of those, 49% planned further educational activities and 75% planned to implement some form of CQI activity. Comparison of responses in relation to the type of presentation received suggested that on-site presentations are associated with higher response rates and more intense quality improvement efforts. This also could be attributed to other factors such as hospital size, teaching environment, or number of acute myocardial infarction patients treated.
The system developed allowed us to collate hospital improvement efforts as a result of CCP. The system is limited in its ability to identify those activities taking place before CCP. Further development and refinement of the tool is warranted to document quality improvement efforts and determine best strategies for peer review organization intervention.
任何持续质量改进（CQI）项目的总体成功取决于衡量项目所产生变化的能力，并证明这些变化已带来了更好的医疗护理。
开发了一种软件工具，用于对医院因合作心血管项目（CCP）而做出的反应和实施的活动进行分类。收集了有关医院对数据的接受情况以及所实施的教育/干预策略的信息。输入医院规模、治疗的急性心肌梗死患者数量、指标表现以及所进行展示的类型（现场展示与区域访问），以便分析影响反应的因素。
107家医院中有61家回应了同行评审组织。其中，49%计划开展进一步的教育活动，75%计划实施某种形式的CQI活动。根据所收到展示类型对反应进行的比较表明，现场展示与更高的回应率以及更强烈的质量改进努力相关。这也可能归因于其他因素，如医院规模、教学环境或治疗的急性心肌梗死患者数量。
所开发的系统使我们能够整理因CCP而开展的医院改进工作。该系统在识别CCP之前所开展活动的能力方面存在局限性。有必要对该工具进行进一步开发和完善，以记录质量改进工作，并确定同行评审组织干预的最佳策略。
