Janssen Birgit, van Brederode Michael, Kitzig Friedhelm, Schmidt-Kraepelin Christian, Ohm Sven, Gaebel Wolfgang
LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität Düsseldorf.
Z Evid Fortbild Qual Gesundhwes. 2011;105(5):371-5. doi: 10.1016/j.zefq.2011.05.016. Epub 2011 Jun 16.
The aim of this project was to improve treatment processes and results in acutely ill inpatients within a network of nine psychiatric state hospitals of the Landschaftsverband Rheinland by introducing a benchmarking process. The project was based upon pre-existing measures of quality management. Patient groups were selected that were characterised by a severe clinical development or a high demand for mental health care services (alcohol abuse, depression of the elderly, schizophrenia). Room for improvement concerning specific hospitals and the overall hospital network were identified. The project was conducted with two patient cohorts before and after a quality-related intervention. Interventions were implemented for specific hospitals and the overall hospital network. Overall treatment documentations of 1,696 patients (1(st) cohort n=1,856, 2(nd) cohort n=1,696) were completed. Although there was no constant quantifiable statistically significant improvement of quality within the three patient groups (and certainly not with respect to the overall network), there was successful improvement of essential treatment processes for certain hospitals and the overall network under benchmarking. This was especially relevant where treatment recommendations were concerned. Future projects should focus on the conformance with treatment guidelines by defining both structural and process measures as a starting point and evaluation criterion.
该项目的目标是通过引入基准化流程，改善莱茵兰地区 Landschaftsverband 九家精神病专科医院网络中急性病住院患者的治疗流程和治疗效果。该项目基于现有的质量管理措施。选择了以严重临床进展或对精神卫生保健服务有高需求为特征的患者群体（酒精滥用、老年抑郁症、精神分裂症）。确定了特定医院和整个医院网络在改进方面的空间。该项目在质量相关干预前后对两个患者队列进行。针对特定医院和整个医院网络实施了干预措施。完成了 1696 名患者的总体治疗记录（第一队列 n = 1856，第二队列 n = 1696）。虽然在三个患者群体中质量没有持续可量化的统计学显著改善（当然整个网络也没有），但在基准化下，某些医院和整个网络的基本治疗流程有了成功改善。在治疗建议方面尤其如此。未来的项目应通过将结构和流程措施都定义为起点和评估标准，专注于符合治疗指南。
