Harvey G, Wensing M
Royal College of Nursing Institute, Radcliffe Infirmary, Oxford OX2 6HE, UK.
Qual Saf Health Care. 2003 Jun;12(3):210-4. doi: 10.1136/qhc.12.3.210.
Evaluation is an integral component of quality improvement and there is much to be learned from the evaluation of small scale quality improvement initiatives at a local level. This type of evaluation is useful for a number of different reasons including monitoring the impact of local projects, identifying and dealing with issues as they arise within a project, comparing local projects to draw lessons, and collecting more detailed information as part of a bigger evaluation project. Focused audits and developmental studies can be used for evaluation within projects, while methods such as multiple case studies and process evaluations can be used to draw generalised lessons from local experiences and to provide examples of successful projects. Evaluations of small scale quality improvement projects help those involved in improvement initiatives to optimise their choice of interventions and use of resources. Important information to add to the knowledge base of quality improvement in health care can be derived by undertaking formal evaluation of local projects, particularly in relation to building theory around the processes of implementation and increasing understanding of the complex change processes involved.
评估是质量改进不可或缺的组成部分,从对地方层面小规模质量改进举措的评估中可以学到很多东西。这种评估因多种不同原因而有用,包括监测地方项目的影响、在项目中出现问题时识别并处理问题、比较地方项目以吸取经验教训,以及作为更大评估项目的一部分收集更详细的信息。重点审计和发展性研究可用于项目内部的评估,而多案例研究和过程评估等方法可用于从地方经验中得出一般性经验教训,并提供成功项目的实例。对小规模质量改进项目的评估有助于参与改进举措的人员优化干预措施的选择和资源的使用。通过对地方项目进行正式评估,尤其是围绕实施过程构建理论并加深对所涉及的复杂变革过程的理解,可以得出有助于增加医疗保健质量改进知识库的重要信息。