Slora Eric J, Steffes Jennifer M, Harris Donna, Clegg Herbert W, Norton David, Darden Paul M, Sullivan Susan A, Wasserman Richard C
Pediatric Research in Office Settings, American Academy of Pediatrics, Elk Grove Village, IL 60007, USA.
Clin Pediatr (Phila). 2008 Jan;47(1):25-36. doi: 10.1177/0009922807304597. Epub 2007 Aug 10.
The feasibility and effectiveness of a distance-based quality improvement model were examined in a cohort of Pediatric Research in Office Settings (PROS) practices, with the goal of improving immunization rates and practitioner behaviors and attitudes. Of an initially assessed 82 practices, 29 with baseline rates of < or =88% for children 8 to 15 months of age were randomized into year-long paper-based education or distance-based quality improvement intervention groups. Outcomes were utility/helpfulness of quality improvement modalities, immunization rate change, and behavior/attitude change. Quality improvement participants attended approximately 75% of monthly conference calls but used the quality improvement Listserv and Web site infrequently (mean 1.09 and 0.92 uses, respectively). Helpfulness ratings of quality improvement modalities mirrored usage. Analyses revealed a 4.9% increase in quality improvement group immunization rates (P = .061), a 0.8% education group increase (P = .752), and a 4.1% difference between groups (P = .261). More quality improvement practices adopted systems identifying children behind in immunizations. A distance-based quality improvement model is feasible and may improve immunization rates.
在一组门诊环境下的儿科研究（PROS）机构中，对基于远程的质量改进模型的可行性和有效性进行了研究，目的是提高免疫接种率以及从业者的行为和态度。在最初评估的82个机构中，将29个8至15个月龄儿童基线接种率≤88%的机构随机分为为期一年的纸质教育组或基于远程的质量改进干预组。结果包括质量改进模式的实用性/帮助程度、免疫接种率变化以及行为/态度变化。质量改进参与者参加了约75%的月度电话会议，但很少使用质量改进邮件列表和网站（分别平均使用1.09次和0.92次）。质量改进模式的帮助程度评级与使用情况相符。分析显示，质量改进组的免疫接种率提高了4.9%（P = 0.061），教育组提高了0.8%（P = 0.752），两组之间的差异为4.1%（P = 0.261）。更多质量改进机构采用了识别免疫接种落后儿童的系统。基于远程的质量改进模型是可行的，并且可能提高免疫接种率。
