Nabitz Udo, Schramade Mark, Schippers Gerard
Amsterdam Institute for Addiction Research, Academic Medical Center University of Amsterdam, The Netherlands.
Int J Qual Health Care. 2006 Oct;18(5):336-45. doi: 10.1093/intqhc/mzl033. Epub 2006 Aug 26.
To evaluate a treatment process redesign programme implementing evidence-based treatment as part of a total quality management in a Dutch addiction treatment centre.
Quality management was monitored over a period of more than 10 years in an addiction treatment centre with 550 professionals. Changes are evaluated, comparing the scores on the nine criteria of the European Foundation for Quality Management (EFQM) Excellence Model before and after a major redesign of treatment processes and ISO certification.
In the course of 10 years, most intake, care, and cure processes were reorganized, the support processes were restructured and ISO certified, 29 evidence-based treatment protocols were developed and implemented, and patient follow-up measuring was established to make clinical outcomes transparent. Comparing the situation before and after the changes shows that the client satisfaction scores are stable, that the evaluation by personnel and society is inconsistent, and that clinical, production, and financial outcomes are positive. The overall EFQM assessment by external assessors in 2004 shows much higher scores on the nine criteria than the assessment in 1994.
Evidence-based treatment can successfully be implemented in addiction treatment centres through treatment process redesign as part of a total quality management strategy, but not all results are positive.
评估一项治疗流程重新设计计划，该计划将循证治疗作为荷兰一家成瘾治疗中心全面质量管理的一部分。
在一个拥有550名专业人员的成瘾治疗中心，对超过10年的质量管理进行监测。对治疗流程进行重大重新设计并获得ISO认证前后，比较欧洲质量管理基金会（EFQM）卓越模型九个标准的得分，以此评估变化情况。
在10年的时间里，大多数入院、护理和治疗流程进行了重组，支持流程进行了重构并获得ISO认证，制定并实施了29项循证治疗方案，建立了患者随访测量以提高临床结果的透明度。比较变化前后的情况表明，客户满意度得分稳定，员工和社会的评价不一致，临床、生产和财务结果是积极的。2004年外部评估人员对EFQM的总体评估显示，九个标准的得分比1994年的评估高得多。
作为全面质量管理策略的一部分，通过治疗流程重新设计，循证治疗能够在成瘾治疗中心成功实施，但并非所有结果都是积极的。
