Mills Peter D, Weeks William B
Veterans Health Administration (VHA), National Center for Patient Safety, White River Junction VA Medical Center, White River Junction, Vermont, USA.
Jt Comm J Qual Saf. 2004 Mar;30(3):152-62. doi: 10.1016/s1549-3741(04)30017-1.
A pre-post observational design was used to study the aggregate results of five national Breakthrough Series (BTS) collaboratives run within Veterans Health Administration (VHA) to identify the organizational, interpersonal, and systemic characteristics of successful improvement teams.
One hundred thirty-one medical quality improvement teams participated in five BTS collaboratives in the VHA between 1999 and 2002. Team characteristics were assessed using a team questionnaire before and after the BTS collaboratives.
Fifty-seven percent of participating teams were rated as successful (a > or = 20% improvement from baseline for at least two months before the collaboratives' end). More high-performing medical quality improvement teams perceived their work to be part of their organization's key strategic goals. By the end of the BTS collaboratives, high-performing teams had more front-line staff support and stronger team leadership.
Strong organizational support, strong team leadership, and high levels of interpersonal team skills help medical quality improvement teams go further to improve clinical care. It is recommended that quality improvement teams become integrated with their organization's key strategic goals, that improvement teams stay together, and that leadership and team training be provided to improve clinical outcomes.
采用前后观察性设计来研究在退伍军人健康管理局（VHA）内开展的五个全国性突破系列（BTS）合作项目的总体结果，以确定成功的改进团队的组织、人际和系统特征。
1999年至2002年期间，131个医疗质量改进团队参与了VHA的五个BTS合作项目。在BTS合作项目前后，使用团队问卷对团队特征进行评估。
57%的参与团队被评为成功（在合作项目结束前至少两个月内，比基线水平提高≥20%）。更多表现出色的医疗质量改进团队认为他们的工作是其组织关键战略目标的一部分。到BTS合作项目结束时，表现出色的团队获得了更多一线员工的支持，且团队领导力更强。
强大的组织支持、强大的团队领导力和高水平的人际团队技能有助于医疗质量改进团队在改善临床护理方面取得更大进展。建议质量改进团队与组织的关键战略目标相结合，改进团队保持稳定，并提供领导力和团队培训以改善临床结果。
