Niemeijer Gerard C, Does Ronald J M M, de Mast Jeroen, Trip Albert, van den Heuvel Jaap
Department of Traumatology, University Medical Center Groningen, Groningen, The Netherlands.
Qual Manag Health Care. 2011 Apr-Jun;20(2):152-64. doi: 10.1097/QMH.0b013e318213e75c.
The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective.
This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium.
Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated.
The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.
本文旨在创建可操作的知识，使医疗保健服务中流程改进项目的定义更有效。
本研究是对医院流程改进项目的回顾性分析，采用基于案例推理的方法进行项目定义。数据来源为2002年至2009年荷兰和比利时的综合医院、教学医院和学术医院的271个精益六西格玛医疗保健项目的项目文档和医院绩效统计数据。
以统一的格式和术语对样本中改进项目的目标和操作定义进行了分析和结构化。提取早期项目定义中的可重复使用元素，以9个称为通用项目定义的模板形式呈现。这些模板可作为未来流程改进项目的范例，使类似项目的选择、定义和实施更加高效。每个模板都包括详细的原理、以指标形式呈现的操作化内容以及一个典型示例。因此，促进了基于案例推理的渐进式和持续性学习过程。
项目定义的质量是改善医疗保健服务追求中的关键成功因素。我们提供了9个经过实践检验的与患者安全、患者满意度和医院商业经济绩效相关的改进主题。
