Lombarts M J M H, Rupp I, Vallejo P, Suñol R, Klazinga N S
Academic Medical Center, Department of Social Medicine, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE Amsterdam, the Netherlands.
Qual Saf Health Care. 2009 Feb;18 Suppl 1(Suppl_1):i28-37. doi: 10.1136/qshc.2008.029363.
This study was part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project investigating the impact of quality improvement strategies on hospital care in various countries of the European Union (EU), in relation to specific needs of cross-border patients.
This paper describes how EU hospitals have applied seven quality improvement strategies previously defined by the MARQuIS study: organisational quality management programmes; systems for obtaining patients' views; patient safety systems; audit and internal assessment of clinical standards; clinical and practice guidelines; performance indicators; and external assessment.
A web-based questionnaire was used to survey acute care hospitals in eight EU countries. The reported findings were later validated via on-site survey and site visits in a sample of the participating hospitals. Data collection took place from April to August 2006.
389 hospitals participated in the survey; response rates varied per country. All seven quality improvement strategies were widely used in European countries. Activities related to external assessment were the most broadly applied across Europe, and activities related to patient involvement were the least widely implemented. No one country implemented all quality strategies at all hospitals. There were no differences between participating hospitals in western and eastern European countries regarding the application of quality improvement strategies.
Implementation varied per country and per quality improvement strategy, leaving considerable scope for progress in quality improvements. The results may contribute to benchmarking activities in European countries, and point to further areas of research to explore the relationship between the application of quality improvement strategies and actual hospital performance.
本研究是评估质量改进策略响应方法（MARQuIS）研究项目的一部分，该项目调查了质量改进策略对欧盟各国医院护理的影响，涉及跨境患者的特定需求。
本文描述了欧盟医院如何应用MARQuIS研究先前定义的七种质量改进策略：组织质量管理计划；获取患者意见的系统；患者安全系统；临床标准的审核和内部评估；临床和实践指南；绩效指标；以及外部评估。
使用基于网络的问卷对八个欧盟国家的急症护理医院进行调查。随后通过对部分参与医院的现场调查和实地访问对报告的结果进行验证。数据收集于2006年4月至8月进行。
389家医院参与了调查；各国的回复率各不相同。所有七种质量改进策略在欧洲国家都被广泛使用。与外部评估相关的活动在欧洲应用最广泛，与患者参与相关的活动实施得最不广泛。没有一个国家在所有医院实施所有质量策略。在质量改进策略的应用方面，西欧和东欧的参与医院之间没有差异。
各国和各质量改进策略的实施情况各不相同，质量改进仍有很大的进步空间。这些结果可能有助于欧洲国家的基准测试活动，并指出进一步的研究领域，以探索质量改进策略的应用与医院实际绩效之间的关系。
