Vestre Viken Health Trust Ringerike, Honefoss, Norway.
BMJ Qual Saf. 2011 Mar;20(3):251-9. doi: 10.1136/bmjqs.2009.038604. Epub 2011 Jan 5.
The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge.
To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered.
Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity.
The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements.
A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.
突破系列协作的目标是缩小我们所知与所为之间的差距，并通过协作学习为医疗保健的持续质量改进（CQI）做出贡献。改进工作以系统的方法为指导，结合专业知识和改进知识。
探讨改进团队从参与协作以及处理遇到的促进和抑制因素中学到了什么。
采用关键事件技术，对 4 个焦点小组中的 19 名团队成员进行了定性访谈。关键事件是指对某项活动产生重大积极或消极贡献的事件。
关键事件揭示了改进文化的要素，反映了协作学习的知识的八个领域。个人的改进知识和技能是重要的要素，但不足以实现可持续的变革。90%的材料反映了需要建立一个 CQI 系统来解决组织在努力实现持久改进时所面临的问题。
出现了 CQI 的三个成功因素模式：（1）关于最佳和当前实践的持续和可靠的信息，包括测量；（2）在改进工作的所有阶段都让每个人参与：患者和家属、领导层、专业环境和员工；（3）基于改进知识的基础设施，拥有多学科团队、可用的指导、学习系统和可持续性系统。
