Steiner Rose M, Walsworth David T
Michigan Improving Performance in Practice, Automotive Industry Action Group, 3600 Cottage Grove Court, Saginaw, MI 48604, USA.
J Contin Educ Health Prof. 2010 Spring;30(2):95-105. doi: 10.1002/chp.20065.
Improving Performance in Practice (IPIP) is an initiative convened by the American Board of Medical Specialties. It investigates the efficacy of coaches in helping primary-care practices improve the care of patients with diabetes and asthma. Most IPIP states use coaches who have a health care background, and are trained in quality and process improvement. Michigan uses quality experts from the manufacturing industry who are educated regarding the health care environment, which enables them to perform as quality-improvement coaches (QICs) in primary-care practices.
In this case study, ninety-six quality experts were trained to coach primary-care practices, with 53 currently assigned to offices, and others assisting as needed. Practice teams and QICs identify gaps in care and office practices with the use of assorted quality-improvement tools. Reports are made monthly to describe clinical and process measures and methods used.
Michigan has 33 practices engaged, involving 205 physicians and 40 midlevel providers. The teaming of quality experts from the manufacturing industry with primary-care office providers and staff resulted in office efficiency, improved care provided, and progress toward attainment of a patient-centered medical home (PCMH).
Quality experts from manufacturing volunteered to coach for improvements in primary care. The efforts of QICs have been successful. Because the QICs are volunteers, sustainability of the Michigan Improving Performance in Practice program is a challenge.
提升实践表现(IPIP)是美国医学专业委员会发起的一项倡议。该倡议调查了教练在帮助初级保健机构改善糖尿病和哮喘患者护理方面的效果。大多数IPIP项目州使用具有医疗保健背景且接受过质量与流程改进培训的教练。密歇根州则使用来自制造业的质量专家,这些专家接受过医疗保健环境方面的培训,从而能够在初级保健机构中担任质量改进教练(QIC)。
在本案例研究中,96名质量专家接受了培训,以指导初级保健机构,其中53名目前已被分配到各诊所,其他人员按需提供协助。实践团队和QIC利用各种质量改进工具来识别护理和诊所实践中的差距。每月都会提交报告,描述所采用的临床和流程指标及方法。
密歇根州有33个机构参与其中,涉及205名医生和40名中级医疗人员。制造业的质量专家与初级保健诊所的医护人员和工作人员合作,提高了诊所效率,改善了护理质量,并朝着实现以患者为中心的医疗之家(PCMH)迈进。
来自制造业的质量专家自愿担任教练,以改善初级保健。QIC的努力取得了成功。由于QIC是志愿者,密歇根州提升实践表现项目的可持续性是一项挑战。