Vallejo Paula, Saura Rosa Maria, Sunol Rosa, Kazandjian Vahe, Ureña Victoria, Mauri Jordi
Avedis Donabedian Foundation, Barcelona, Spain.
Int J Qual Health Care. 2006 Oct;18(5):327-35. doi: 10.1093/intqhc/mzl037.
The use of the European Foundation for Quality Management (EFQM) Model in health care has found that this model is useful in promoting quality improvement, but its use in health care organizations is challenging because being a generic model, it does not cover the clinical aspects or the specifics of this field. For that reason, this article aims to bring the EFQM fundamental concepts of excellence closer to health care, using a specific model as a reference to this field: the Performance Assessment Tool for quality improvement in Hospitals (PATH) conceptual framework, developed by the WHO Regional Office for Europe.
A content analysis was performed to independently identify the contents that defined the elements of both frameworks. Then, using defined criteria, two independent researchers compared the contents of the elements of both frameworks. The elements from both frameworks that were equivalent were aggregated. Several experts discussed the aspects with discrepancies between the two comparisons. Finally, the EFQM framework is adapted to health care by adding to those aggregated elements the aspects that were exclusive from one of the models.
The EFQM framework has many correspondences to a health care-specific framework. The EFQM-health care-adapted framework has eight quality dimensions, two of them (customer focus and safety) being overlapped with the other six (staff, results orientation, responsive governance, leadership and constancy of purpose, clinical effectiveness, and partnership development). This model also has two methodological dimensions (management by processes and facts and continuous learning; improvement and innovation).
This adapted model seems useful for health care organizations, but it needs to be further used to corroborate this preliminary finding.
欧洲质量管理基金会（EFQM）模型在医疗保健领域的应用发现，该模型有助于促进质量改进，但在医疗保健组织中的应用具有挑战性，因为作为一个通用模型，它没有涵盖该领域的临床方面或具体细节。因此，本文旨在通过使用一个针对该领域的特定模型——世界卫生组织欧洲区域办事处开发的医院质量改进绩效评估工具（PATH）概念框架，使EFQM卓越的基本概念更贴近医疗保健领域。
进行了一项内容分析，以独立识别定义两个框架要素的内容。然后，使用既定标准，两名独立研究人员比较了两个框架要素的内容。对两个框架中相等的要素进行了汇总。几位专家讨论了两次比较之间存在差异的方面。最后，通过在汇总要素中添加其中一个模型独有的方面，使EFQM框架适用于医疗保健领域。
EFQM框架与特定于医疗保健的框架有许多对应之处。经调整适用于医疗保健领域的EFQM框架有八个质量维度，其中两个维度（以客户为中心和安全）与其他六个维度（员工、结果导向、响应式治理、领导和目标的持续性、临床有效性以及伙伴关系发展）重叠。该模型还有两个方法维度（流程和事实管理以及持续学习；改进和创新）。
这个调整后的模型似乎对医疗保健组织有用，但需要进一步应用以证实这一初步发现。
