Boyle Brendan M, Palmer Lena, Kappelman Michael D
Nationwide Children's Hospital, Columbus, OH, USA.
J Pediatr Gastroenterol Nutr. 2009 Sep;49(3):272-82. doi: 10.1097/MPG.0b013e3181a491e7.
The Institute of Medicine's publications To Error is Human and Crossing the Quality Chasm publicized the widespread deficits in US health care quality. Emerging studies continue to reveal deficits in the quality of adult and pediatric care, including subspecialty care. In recent years, key stakeholders in the health care system including providers, purchasers, and the public have been applying various quality improvement methods to address these concerns. Lessons learned from these efforts in other pediatric conditions, including asthma, cystic fibrosis, neonatal intensive care, and liver transplantation may be applicable to the care of children with inflammatory bowel disease (IBD).This review is intended to be a primer on the quality of care movement in the United States, with a focus on pediatric IBD. In this article, we review the history, rationale, and methods of quality measurement and improvement, and we discuss the unique challenges in adapting these general strategies to pediatric IBD care.
美国医学研究所出版的《人都会犯错》和《跨越质量鸿沟》揭示了美国医疗保健质量方面普遍存在的缺陷。新出现的研究不断揭示成人和儿科护理质量方面的缺陷，包括专科护理。近年来，医疗保健系统中的主要利益相关者，包括医疗服务提供者、购买者和公众，一直在应用各种质量改进方法来解决这些问题。从其他儿科疾病（包括哮喘、囊性纤维化、新生儿重症监护和肝移植）的这些努力中学到的经验教训，可能适用于炎症性肠病（IBD）患儿的护理。本综述旨在作为美国护理质量运动的入门介绍，重点关注儿科IBD。在本文中，我们回顾了质量测量和改进的历史、基本原理和方法，并讨论了将这些一般策略应用于儿科IBD护理时面临的独特挑战。
