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基于基础文档系统和扩展评估研究的临床质量保证的可能性

[Possibilities in clinical quality assurance founded on a basis documentation system and extended evaluation studies].

作者信息

Schmidt J, Nübling R, Lamprecht F

机构信息

Psychosomatiche Klinik Schömberg.

出版信息

Gesundheitswesen. 1992 Feb;54(2):70-80.

PMID:1554988
Abstract

Although the topic of quality control (QC) has been under discussion at least since the "Health Reform Legislation" (GRG) in almost all areas of the public health system, there is quite often a lack of models for practicability. Even for inpatient medical rehabilitation--at least concerning empirically founded QC-measures suitable methods and instruments have still to be developed. These must be relatively simple and economical to be integrated in the daily routine within a special clinic, if quality control should function. Starting from a broad concept of evaluation, the authors present a practical empirical QC-model for clinics, specifically for psychosomatic rehabilitation, which has been developed and proven for more than five years. To investigate the "programme" of the clinic, or particular program components (e.g. patients, treatments, outcome criteria) with systematically obtained data and analysis, is the main goal of this model. Where statements are replaced by empirically proven data. Aspects of process and outcome quality are considered to be a main task, and transparency is a necessary supposition. This model is particularly based on questionnaire procedures, is two-tracked, e.g. it is composed by continuous data collection ("treatment documentation") on the one hand and by time-restricted and defined studies for programme evaluation on the other. The treatment results represent the true target variable.

摘要

尽管至少自“健康改革立法”(GRG)以来,质量控制(QC)这一话题在公共卫生系统的几乎所有领域都在讨论,但实用性模型往往匮乏。即使对于住院医疗康复而言——至少就基于实证的质量控制措施来说,合适的方法和工具仍有待开发。如果质量控制要发挥作用,这些方法和工具必须相对简单且经济,以便融入特定诊所的日常工作中。从广泛的评估概念出发,作者提出了一种适用于诊所的实用实证质量控制模型,特别是针对心身康复,该模型已经开发并验证了五年多。用系统获取的数据和分析来研究诊所的“项目”或特定项目组成部分(如患者、治疗、结果标准),是该模型的主要目标。在此,论断由经实证验证的数据取代。过程质量和结果质量方面被视为主要任务,透明度是必要前提。该模型特别基于问卷调查程序,具有双轨性,例如,它一方面由持续的数据收集(“治疗记录”)组成,另一方面由针对项目评估的限时且明确的研究组成。治疗结果是真正的目标变量。

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