Harrington J Timothy
Department of Medicine, University of Wisconsin School of Medicine and Public Health, One South Park Street, Madison, WI 53715, USA.
Curr Opin Rheumatol. 2008 Mar;20(2):153-8. doi: 10.1097/BOR.0b013e3282f4b200.
To acquaint rheumatologists with pay-for-performance and the American College of Rheumatology quality initiative, and to suggest how practice process redesigns and effective measurement of performance and disease outcomes will help rheumatologists document and improve the quality of rheumatic disease care.
The options for treating rheumatic diseases have improved, but many patients are not achieving optimal outcomes. Pay for performance programs being introduced by Medicare and other insurers will link provider revenues to quality indicators, requiring rheumatologists to measure, document, and improve their patients' outcomes. Expected rheumatology manpower losses will also require greater practice efficiency and increased reliance on inter-disciplinary care teams. Some publications advocate improving healthcare by expanding research to improve knowledge transfer from clinical studies to clinical practice; others suggest continuous process improvement methods to improve delivery of care processes. Practical disease activity measurements and rheumatology practice improvements are being reported that suggest a positive future.
Rheumatologists need to recognize the need to improve delivery of care and patient outcomes, measure and document clinical performance, and learn the methods for managing clinical process improvement.
使风湿病学家了解按绩效付费及美国风湿病学会质量倡议，并提出实践流程重新设计以及对绩效和疾病结局进行有效测量将如何帮助风湿病学家记录并提高风湿性疾病护理质量。
治疗风湿性疾病的选择有所改善，但许多患者未达到最佳结局。医疗保险和其他保险公司推出的按绩效付费计划将把医疗服务提供者的收入与质量指标挂钩，这要求风湿病学家测量、记录并改善患者的结局。预计风湿病领域的人力流失也将需要更高的实践效率，并更多地依赖跨学科护理团队。一些出版物主张通过扩大研究以改善从临床研究到临床实践的知识转化来改善医疗保健；另一些则建议采用持续流程改进方法来改善护理流程的提供。目前正在报道实用的疾病活动测量方法和风湿病实践改进情况，预示着积极的未来。
风湿病学家需要认识到改善护理提供和患者结局的必要性，测量并记录临床绩效，并学习管理临床流程改进的方法。
