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成功案例：医院如何改善医疗服务。

Success stories: how hospitals are improving care.

作者信息

Roe Matthew T

机构信息

Duke University Medical Center and Duke Clinical Research Institute, Durham, NC 27705, USA.

出版信息

Am Heart J. 2004 Nov;148(5 Suppl):S52-5. doi: 10.1016/j.ahj.2004.09.017.

DOI:10.1016/j.ahj.2004.09.017
PMID:15514636
Abstract

What does it take to make changes in practice and sustain those changes over time? This paper describes 3 successful attempts to improve the quality of care at US hospitals participating in the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology [ACC]/American Heart Association [AHA] Guidelines), the Guidelines Applied in Practice (GAP), and the Get With The Guidelines (GWTG) programs. Techniques that work at the local level and practical tips that can be adopted to develop quality improvement (QI) initiatives are highlighted.

摘要

要在实践中做出改变并长期维持这些改变需要什么？本文描述了三项成功的尝试，这些尝试旨在提高参与“CRUSADE（不稳定型心绞痛患者快速风险分层能否通过早期实施美国心脏病学会[ACC]/美国心脏协会[AHA]指南来抑制不良结局）”“实践中应用指南（GAP）”以及“遵循指南（GWTG）”项目的美国医院的医疗质量。文中强调了在地方层面有效的技术以及可用于制定质量改进（QI）举措的实用技巧。

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Success stories: how hospitals are improving care.成功案例：医院如何改善医疗服务。
Am Heart J. 2004 Nov;148(5 Suppl):S52-5. doi: 10.1016/j.ahj.2004.09.017.
2
A framework for quality improvement: an analysis of factors responsible for improvement at hospitals participating in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) quality improvement initiative.质量改进框架：对参与“不稳定型心绞痛患者能否通过早期实施美国心脏病学会/美国心脏协会指南抑制不良结局的快速风险分层（CRUSADE）”质量改进倡议的医院中促成改进的因素进行分析。
Am Heart J. 2007 Dec;154(6):1206-20. doi: 10.1016/j.ahj.2007.08.001. Epub 2007 Sep 14.
3
Recent trends in the care of patients with non-ST-segment elevation acute coronary syndromes: insights from the CRUSADE initiative.非ST段抬高型急性冠脉综合征患者护理的近期趋势：来自CRUSADE倡议的见解
Arch Intern Med. 2006 Oct 9;166(18):2027-34. doi: 10.1001/archinte.166.18.2027.
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Patterns of guideline adherence and care delivery for patients with unstable angina and non-ST-segment elevation myocardial infarction (from the CRUSADE Quality Improvement Initiative).不稳定型心绞痛和非ST段抬高型心肌梗死患者的指南遵循模式与医疗服务提供情况（来自CRUSADE质量改进倡议）
Am J Cardiol. 2006 Dec 18;98(12A):30Q-35Q. doi: 10.1016/j.amjcard.2006.09.022. Epub 2006 Oct 23.
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A quality guarantee in acute coronary syndromes: the American College of Cardiology's Guidelines Applied in Practice program taken real-time.急性冠状动脉综合征的质量保证：美国心脏病学会“实践应用指南”项目的实时情况。
Am Heart J. 2007 Jan;153(1):16-21. doi: 10.1016/j.ahj.2006.09.002.
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Acad Emerg Med. 2007 Nov;14(11):949-54. doi: 10.1197/j.aem.2007.06.017.
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Antiplatelet therapy in patients with unstable angina and non-ST-segment-elevation myocardial infarction: findings from the CRUSADE national quality improvement initiative.不稳定型心绞痛和非ST段抬高型心肌梗死患者的抗血小板治疗：CRUSADE全国质量改进计划的研究结果
Pharmacotherapy. 2007 Aug;27(8):1145-62. doi: 10.1592/phco.27.8.1145.
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Gender differences in time to presentation for myocardial infarction before and after a national women's cardiovascular awareness campaign: a temporal analysis from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes with Early Implementation (CRUSADE) and the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network-Get with the Guidelines (NCDR ACTION Registry-GWTG).在全国女性心血管意识宣传活动前后，心肌梗死患者就诊时间的性别差异：来自加拿大不稳定型心绞痛患者快速危险分层以早期实施（CRUSADE）和国家心血管数据登记急性冠状动脉治疗和干预结局网络-遵循指南（NCDR ACTION Registry-GWTG）的时间分析。
Am Heart J. 2010 Jul;160(1):80-87.e3. doi: 10.1016/j.ahj.2010.04.017.
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The American Heart Association Get With The Guidelines program.美国心脏协会“遵循指南”项目。
Am Heart J. 2004 Nov;148(5 Suppl):S46-8. doi: 10.1016/j.ahj.2004.09.015.
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Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative.非ST段抬高型急性冠状动脉综合征诊断与治疗中的性别差异：来自CRUSADE（不稳定型心绞痛患者快速风险分层能否通过早期实施美国心脏病学会/美国心脏协会指南抑制不良结局）国家质量改进计划的大规模观察结果
J Am Coll Cardiol. 2005 Mar 15;45(6):832-7. doi: 10.1016/j.jacc.2004.11.055.

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