Fontanesi John, Mendoza Stanley, Bowers Debra, Reznik Vivian
Center for Management Science in Health, Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, #0821, La Jolla, CA, 92093, USA.
J Med Pract Manage. 2009 Jan-Feb;24(4):248-53.
Despite the ubiquity problems with pay-for-performance and other quality improvement initiatives, there is little in the way of objective evidence that these efforts have improved the quality of care. In part, it may be because the measurements selected are used to "grade" instead of guide improvement efforts. We propose using operational research methods that include how to develop "guiding measurements" to improve care. We show that use of this type of guiding measurements can lead to improved patient understanding, throughput, and satisfaction in a pediatric nephrology ambulatory care clinic, and may have wider applications across the continuum of care.
尽管按绩效付费及其他质量改进举措存在普遍问题，但几乎没有客观证据表明这些努力提高了医疗质量。部分原因可能是所选的衡量指标被用于“评分”而非指导改进工作。我们建议使用运筹学方法，包括如何制定“指导性衡量指标”以改善医疗服务。我们表明，在一家儿科肾脏病门诊使用这类指导性衡量指标可提高患者的理解度、诊疗效率及满意度，并且可能在整个医疗连续过程中有更广泛的应用。
