Griffin Frances A
Institute for Healthcare Improvement, Cambridge, MA, USA.
Jt Comm J Qual Patient Saf. 2007 Nov;33(11):660-5. doi: 10.1016/s1553-7250(07)33075-4.
One of the 12 interventions that the Institute for Healthcare Improvement (IHI) recommends for its 5 Million Lives Campaign is "Reduce Surgical Complications...by reliably implementing all the changes in care recommended by the Surgical Care Improvement Project (SCIP)." Many surgical patients experience complications from surgery, some of which are preventable with the reliable application of evidence-based medicine. Despite promotion and dissemination of recommendations and practices, overall national compliance remains less than optimal.
IHI's 5 Million Lives Campaign is supporting the recommended practices in the SCIP to accelerate adoption for reduction in surgical complications by 25% by December 2008. Practices relate to surgical site infection prevention, prophylaxis for venousthromboembolism, continuation of beta blockers, and prevention of postoperative pneumonia. Strategies used in hospitals that have achieved improvement in the recommended SCIP measures include practices that increase reliability and minimize practice variation. These changes, along with efforts to improve teamwork and communication, are essential to reduce surgical complications.
Organizations that strive for high reliability in their processes should see improvement in the associated outcomes and a reduction in harm to patients.
医疗改进研究所（IHI）为其“拯救500万人生命运动”推荐的12项干预措施之一是“通过切实执行外科护理改进项目（SCIP）推荐的所有护理变更来减少手术并发症……”。许多手术患者会经历手术并发症，其中一些并发症可通过切实应用循证医学来预防。尽管推荐意见和做法得到了推广和传播，但全国总体合规情况仍不尽如人意。
IHI的“拯救500万人生命运动”支持SCIP中的推荐做法，以加速采用这些做法，到2008年12月将手术并发症减少25%。这些做法涉及预防手术部位感染、预防静脉血栓栓塞、继续使用β受体阻滞剂以及预防术后肺炎。在SCIP推荐措施方面取得改进的医院所采用的策略包括提高可靠性和尽量减少做法差异的措施。这些变更以及改善团队合作和沟通的努力对于减少手术并发症至关重要。
在其流程中追求高可靠性的组织应会看到相关结果有所改善，对患者的伤害减少。
