Fleischut Peter M, Faggiani Susan L, Evans Adam S, Brenner Samantha, Liebowitz Richard S, Forese Laura, Kerr Gregory E, Lazar Eliot J
Department of Anesthesiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City, NY, USA.
Jt Comm J Qual Patient Saf. 2012 Jul;38(7):311-7. doi: 10.1016/s1553-7250(12)38041-0.
In 2008 New York-Presbyterian Hospital (NYP)/Weill Cornell Medical Center, New York City, the largest not-for-profit, nonsectarian hospital in the United States, created and implemented a novel approach--the Housestaff Quality Council (HQC)--to engaging house-staff in quality and patient safety activities.
The HQC represented an innovative collaboration between the housestaff, the Department of Anesthesiology, the Division of Quality and Patient Safety, the Office of Graduate Medical Education, and senior leadership. As key managers of patient care, the housestaff sought to become involved in the quality and patient safety decision- and policy-making processes at the hospital. Its members were determined to decrease or minimize adverse events by facilitating multimodal communication, ensuring smart work flow, and measuring outcomes to determine best practices. The HQC, which also included frontline hospital staff or managers from areas such as nursing, pharmacy, and information technology, aligned its initiatives with those of the division of quality and patient safety and embarked on two projects--medication reconciliation and use of the electronic medical record. More than three years later, the resulting improvements have been sustained and three new projects--hand hygiene, central line-associated bloodstream infections, and patient handoffs--have been initiated.
The HQC model is highly replicable at other teaching institutions as a complementary approach to their other quality and patient safety initiatives. However, the ability to sustain positive momentum is dependent on the ability of residents to invest time and effort in the face of a demanding residency training schedule and focus on specialty-specific clinical and research activities.
2008年，美国最大的非营利性、非宗派医院纽约长老会医院（NYP）/威尔康奈尔医学院在纽约市创建并实施了一种新颖的方法——住院医师质量委员会（HQC），以促使住院医师参与质量和患者安全活动。
HQC代表了住院医师、麻醉科、质量与患者安全部门、毕业后医学教育办公室以及高级领导层之间的创新性合作。作为患者护理的关键管理者，住院医师试图参与医院质量和患者安全决策及政策制定过程。其成员决心通过促进多模式沟通、确保合理的工作流程以及衡量结果以确定最佳实践，来减少或最小化不良事件。HQC还包括来自护理、药学和信息技术等领域的医院一线工作人员或管理人员，使其举措与质量和患者安全部门的举措保持一致，并开展了两个项目——用药核对和电子病历的使用。三年多后，所取得的改进得以持续，并且启动了三个新项目——手卫生、中心静脉导管相关血流感染和患者交接。
作为其他质量和患者安全举措的补充方法，HQC模式在其他教学机构具有高度可复制性。然而，保持积极势头的能力取决于住院医师在紧张的住院医师培训日程安排下投入时间和精力的能力，以及专注于特定专业临床和研究活动的能力。
