Director of the Institute for Leadership and Service Improvement, Faculty of Health and Social Care, London South Bank University. 103 Borough Road, London SE1 0AA, UK.
Int J Qual Health Care. 2011 Dec;23(6):637-44. doi: 10.1093/intqhc/mzr055. Epub 2011 Aug 16.
Many approaches to measuring quality in healthcare exist, generally employing indicators or metrics. While there are important differences, most of these approaches share three key areas of measurement: safety, effectiveness and patient experience. The European Partnership for Supervisory Organisations in Health Services and Social Care (EPSO) exists as a working group and discussion forum for European regulators. This group undertook to identify a common framework within which European approaches to indicators could be compared.
A framework was developed to classify indicators, using four sets of criteria: conceptualization of quality, Donabedian definition (structure, process, outcome), data type (derivable, collectable from routine sources, special collections, samples) and data use (judgement (singular or part of framework) benchmarking, risk assessment). Indicators from English and Dutch hospital measurement programmes were put into the framework, showing areas of agreement and levels of comparability. In the first instance, results are only illustrative.
The EPSO has been a powerful driver for undertaking cross-European research, and this project is the first of many to take advantage of the access to international expertize. It has shown that through development of a framework that deconstructs national indicators, commonalities can be identified. Future work will attempt to incorporate other nations' indicators, and attempt cross-national comparison.
许多医疗保健质量衡量方法都存在,通常采用指标或指标。虽然存在重要差异,但这些方法大多都有三个关键测量领域:安全性、有效性和患者体验。欧洲卫生服务和社会保健监管机构合作组织(EPSO)是一个工作组和讨论论坛,为欧洲监管机构提供服务。该组织承担了确定一个共同框架的任务,以便可以在该框架内比较欧洲的指标方法。
使用四组标准开发了一个框架来对指标进行分类:质量概念化、Donabedian 定义(结构、过程、结果)、数据类型(可推断、可从常规来源、特殊收集、样本中收集)和数据用途(判断(单一或框架的一部分)基准、风险评估)。将来自英国和荷兰医院测量计划的指标放入框架中,显示出一致性和可比性的程度。在最初阶段,结果仅具有说明性。
EPSO 一直是进行跨欧洲研究的强大动力,该项目是利用国际专业知识的众多项目中的第一个。它表明,通过构建一个解构国家指标的框架,可以确定共同之处。未来的工作将尝试纳入其他国家的指标,并尝试跨国比较。