Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46032, USA.
Clin J Am Soc Nephrol. 2011 Jun;6(6):1507-11. doi: 10.2215/CJN.11461210. Epub 2011 May 19.
An abundance of available laboratory information has led in part to the establishment of quantitative performance goals that use serum albumin, hemoglobin, Kt/V, and bone mineral indices to track quality of medical care and even physician reimbursement. As we look to the future, the next generation of measures should should more specifically reflect efforts to improve more fundamental outcomes, such as mortality, hospitalization, and quality of life. In this essay we address the important question of how clinicians can translate rich sources of quantitative data into a service that makes a difference in our patients' lives; a way to distinguish exemplary from ordinary care; a means to support continuous improvement in our care patterns individually and as part of larger, integrated health care systems all while avoiding prematurely advocating flawed quality measures. We also offer a pathway for how future quality measures can be developed. Our ultimate goal is to individualize quantitative assessments and by doing so encourage more meaningful, patient-oriented care that will lead to improved outcomes, greater physician job satisfaction, and wiser allocation of scarce resources.
大量现有的实验室信息在一定程度上促成了定量绩效目标的建立，这些目标使用血清白蛋白、血红蛋白、Kt/V 和骨矿物质指数来跟踪医疗保健质量，甚至医生的报酬。展望未来，下一代措施应该更具体地反映出改善更基本结果的努力，如死亡率、住院率和生活质量。在本文中，我们探讨了一个重要问题，即临床医生如何将丰富的定量数据转化为一种服务，从而改善患者的生活；一种区分卓越护理和普通护理的方法；一种支持我们个人和作为更大的综合医疗保健系统一部分的护理模式持续改进的手段，同时避免过早提倡有缺陷的质量措施。我们还提供了一个未来质量措施如何制定的途径。我们的最终目标是对定量评估进行个性化，从而鼓励更有意义、以患者为中心的护理，这将导致改善结果、提高医生的工作满意度和更明智地分配稀缺资源。
