Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario L8N 4A6, Canada.
Surg Oncol. 2011 Sep;20(3):179-83. doi: 10.1016/j.suronc.2011.02.002. Epub 2011 Mar 9.
Deliberate quality improvement in surgical oncology can optimize patient outcomes, by ensuring the application of current best knowledge and practice to our patients. We hypothesize that effective projects should support surgeons performing cancer operations, and avoid the prevalent tendency to focus on identifying 'bad apples' or surgeons not meeting a pre-set bar of performance. As well, the overall quality effort must be data driven. A useful framework to assist in developing a quality improvement project includes the following steps: 1) debate and select values and goals that will inform the effort; 2) select a clinical area for improvement; 3) select team members; 4) select relevant quality markers for improvement; 5) collect data for selected markers; 6) select and operationalize interventions; and, 7) re-evaluate, potentially modify, and potentially repeat the above steps. Common sense, a well thought out process, and good will, will likely lead to improvements in the outcomes of patients.
外科肿瘤学中的刻意质量改进可以通过确保将当前最佳知识和实践应用于我们的患者，从而优化患者的结果。我们假设，有效的项目应该支持执行癌症手术的外科医生，并避免普遍存在的倾向，即专注于识别“坏苹果”或不符合预先设定绩效标准的外科医生。此外，整体质量工作必须基于数据。一个有用的框架，可用于协助制定质量改进项目，包括以下步骤：1）辩论并选择将为工作提供信息的价值观和目标；2）选择要改进的临床领域；3）选择团队成员；4）选择相关的质量改进标志物；5）收集选定标志物的数据；6）选择并实施干预措施；以及 7）重新评估、可能修改并可能重复上述步骤。常识、深思熟虑的过程和良好的意愿，很可能会提高患者的治疗效果。
