Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, Ohio State University, College of Medicine, Columbus, Ohio, USA.
Pediatrics. 2011 Jun;127(6):1147-56. doi: 10.1542/peds.2010-1409. Epub 2011 May 16.
Children's hospitals and their affiliated departments of pediatrics often pursue separate programs in quality and safety; by integrating these programs, they can accelerate progress. Hospital executives and pediatric department chairs from 14 children's hospitals have been exploring practical approaches for integrating quality programs. Three components provide focus: (1) alignment of quality priorities and resources across the organizations; (2) education and training for physicians in the science of improvement; and (3) professional development and career progression for physicians in recognition of quality-improvement activities. Process and resource requirements are identified for each component, and specific, actionable steps are identified. The action steps are arrayed on a continuum from basic to advanced integration. The resulting matrix serves as an "integration framework," useful to a hospital and its pediatric academic department at any stage of integration for assessing its current state, plotting a path toward further integration, tracking its progress, and identifying potential collaborators and models of advanced integration. The framework contributes to health care's quality-improvement movement in multiple ways: it addresses a basic impediment to quality and safety improvement; it is an implementable model for integrating quality programs; it offers career-advancement potential for physicians interested in quality; it helps optimize investments in quality and safety; and it can be applied both within a single children's hospital and across multiple children's hospitals. Widespread adoption of the integration framework could have a transformative effect on the children's hospital sector, not the least of which is improved quality and safety on a large scale.
儿童医院及其附属儿科部门通常在质量和安全方面追求独立的项目；通过整合这些项目，他们可以加速进展。来自 14 家儿童医院的医院管理人员和儿科主任一直在探索整合质量计划的实用方法。三个部分提供重点：（1）在组织内调整质量优先事项和资源；（2）为医生提供改进科学方面的教育和培训；以及（3）为医生提供专业发展和职业发展，以认可质量改进活动。为每个部分确定了流程和资源要求，并确定了具体的可操作步骤。这些行动步骤按照从基础到高级整合的连续体排列。由此产生的矩阵充当“整合框架”，对任何整合阶段的医院及其儿科学术部门都有用，用于评估其当前状态、规划进一步整合的路径、跟踪其进展以及确定潜在的合作者和高级整合模式。该框架以多种方式为医疗保健的质量改进运动做出贡献：它解决了质量和安全改进的基本障碍；它是整合质量计划的可实施模型；它为有兴趣提高质量的医生提供了职业发展潜力；它有助于优化质量和安全投资；并且可以在单个儿童医院内和多个儿童医院内应用。整合框架的广泛采用可能会对儿童医院部门产生变革性影响，其中最重要的是大规模提高质量和安全性。
