Pronovost Peter J, Nolan Thomas, Zeger Scott, Miller Marlene, Rubin Haya
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA.
Lancet. 2004 Mar 27;363(9414):1061-7. doi: 10.1016/S0140-6736(04)15843-1.
The demand for high quality care is increasing and warranted. Evidence suggests that the quality of care in hospitals can be improved. The greatest opportunity to improve outcomes for patients over the next quarter century will probably come not from discovering new treatments but from learning how to deliver existing effective therapies. To improve, caregivers need to know what to do, how they are doing, and be able to improve the processes of care. The ability to monitor performance, though challenging in healthcare, is essential to improving quality of care. We present a practical method to assess and learn from routine practice. Methods to evaluate performance from industrial engineering can be broadly applied to efforts to improve the quality of healthcare. One method that may help to provide caregivers frequent feedback is time series data--ie, results are graphically correlated with time. Broad use of these tools might lead to the necessary improvements in quality of care.
对高质量医疗服务的需求正在增加，这是合理的。有证据表明，医院的医疗质量可以得到改善。在未来二十五年里，改善患者治疗效果的最大机会可能不在于发现新的治疗方法，而在于学习如何提供现有的有效治疗。为了实现改善，医护人员需要知道该做什么、做得如何，并能够改进护理流程。尽管在医疗保健领域进行绩效监测具有挑战性，但它对于提高医疗质量至关重要。我们提出了一种从常规实践中进行评估和学习的实用方法。工业工程中评估绩效的方法可以广泛应用于提高医疗质量的工作中。一种可能有助于为医护人员提供频繁反馈的方法是时间序列数据——即结果与时间进行图形关联。广泛使用这些工具可能会带来医疗质量的必要提升。
