Passo Murray H, Taylor Janalee
Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Curr Opin Rheumatol. 2008 Sep;20(5):625-30. doi: 10.1097/BOR.0b013e32830c690f.
Quality improvement is a mandate for all individuals and institutions in medicine. Quality improvement has spread to the specialty certifying boards, resident education accreditation, licensure boards, and hospital medical staff offices. This review summarizes the thrust of quality improvement, provides justification for the conduct of quality improvement work, and reviews the progress in development of quality measures in rheumatology to date.
The American College of Rheumatology, quality of care, and quality measure committees have developed quality indicators for rheumatoid arthritis, gout, osteoporosis, and drug safety. Pediatric rheumatology is charged with developing quality measures for juvenile idiopathic arthritis; thus, there is a commitment to improve the processes and patient outcomes. Quality improvement science has progressed over the last decade and employs methodology that utilizes small number and rapid improvement cycles. Examples of this quality improvement methodology are elaborated in this review.
The review summarizes the history and current mandates for quality improvement in the medical community, progress made in the development of quality measures for adult rheumatologic conditions, and preliminary quality measures for juvenile idiopathic arthritis, and cites examples of quality improvement in progress in the pediatric rheumatology.
质量改进是医学界所有个人和机构的一项任务。质量改进已扩展到专业认证委员会、住院医师教育认证、执照颁发委员会以及医院医务人员办公室。本综述总结了质量改进的要点，为开展质量改进工作提供了理由，并回顾了迄今为止风湿病学质量指标的发展进展。
美国风湿病学会、医疗质量和质量指标委员会已经制定了类风湿关节炎、痛风、骨质疏松症和药物安全性的质量指标。儿科风湿病学负责制定青少年特发性关节炎的质量指标；因此，致力于改进流程和改善患者预后。质量改进科学在过去十年中取得了进展，并采用了利用少量样本和快速改进周期的方法。本综述详细阐述了这种质量改进方法的实例。
本综述总结了医学界质量改进的历史和当前任务、成人风湿病质量指标的发展进展、青少年特发性关节炎的初步质量指标，并列举了儿科风湿病学正在进行的质量改进实例。
