The Joint Commission, 1 Renaissance Boulevard, Oakbrook Terrace, IL 60181, USA.
Isr J Health Policy Res. 2012 Jan 30;1(1):4. doi: 10.1186/2045-4015-1-4.
Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years. These achievements are all the more notable given Israel's modest overall spending on health care and because they have accrued to virtually the entire population of the country.Health care systems in most developed nations around the world find themselves in a similar position today with respect to health care quality. Despite significantly increased improvement efforts over the past decade, routine safety processes, such as hand hygiene and medication administration, fail routinely at rates of 30% to 50%. People with chronic diseases experience preventable episodes of acute illness that require hospitalization due to medication mix-ups and other failures of outpatient management. Patients continue to be harmed by preventable adverse events, such as surgery on the wrong part of the body and fires in operating theaters. Health care around the world is not nearly as safe as other industries, such as commercial aviation, that have mastered highly effective ways to manage serious hazards.Health care organizations will have to undertake three interrelated changes to get substantially closer to the superlative safety records of other industries: leadership commitment to zero major quality failures, widespread implementation of highly effective process improvement methods, and the adoption of all facets of a culture of safety. Each of these changes represents a major challenge to the way today's health care organizations plan and carry out their daily work. The Israeli health system is in an enviable position to implement these changes. Universal health insurance coverage, the enrolment of the entire population in a small number of health plans, and the widespread use of electronic health records provide advantages available to few other countries.Achieving and sustaining levels of safety comparable to, say, commercial aviation will be a long journey for health care--one we should begin promptly.This is a commentary on http://www.ijhpr.org/content/1/1/3/
以色列近年来在提高社区医疗质量关键指标的绩效方面取得了令人瞩目的进展。鉴于以色列在医疗保健方面的总支出相对较少，而且这些成就几乎惠及该国的全体人民，这些成就更加引人注目。当今，世界上大多数发达国家的医疗保健系统在医疗保健质量方面都处于类似的境地。尽管在过去十年中，人们在改善医疗保健质量方面付出了巨大的努力，但常规的安全流程，如手卫生和药物管理，仍然经常以 30%到 50%的比例失败。慢性病患者由于药物混合和其他门诊管理失败而经历可预防的急性疾病发作，需要住院治疗。患者继续因可预防的不良事件而受到伤害，例如对身体错误部位进行手术和手术室发生火灾。全球的医疗保健远不如商业航空等其他行业安全，商业航空已经掌握了管理严重危害的高效方法。医疗保健组织将不得不进行三项相互关联的变革，以大大接近其他行业的卓越安全记录：领导层承诺实现零重大质量失误，广泛实施高效的流程改进方法，以及采用安全文化的各个方面。这些变革中的每一项都对当今医疗保健组织计划和开展日常工作的方式构成了重大挑战。以色列的医疗体系处于实施这些变革的有利地位。全民健康保险覆盖、全体人口加入少数几个健康计划以及电子健康记录的广泛使用为其他少数几个国家提供了优势。实现并维持与商业航空等行业相当的安全水平将是医疗保健领域的一个漫长旅程——我们应该尽快开始这一旅程。这是对《国际卫生政策与管理杂志》（http://www.ijhpr.org/content/1/1/3/）上的一篇文章的评论。
