美国医疗保健质量运动简史。
Brief history of quality movement in US healthcare.
机构信息
Harvard Combined Orthopaedic Residency Program, 55 Fruit Street, WHT 535, Boston, MA, 02114, USA,
出版信息
Curr Rev Musculoskelet Med. 2012 Dec;5(4):265-73. doi: 10.1007/s12178-012-9137-8.
The current healthcare quality improvement infrastructure is a product of a century long experience of cumulative efforts. It began with an acknowledgement of the role of quality in healthcare, and gradually evolved to encompass the prioritization of quality improvement and the development of systems to monitor, quantify, and incentivize quality improvement in healthcare. We review the origins and the evolution of the US healthcare quality movement, identify existing initiatives specific to musculoskeletal care, outline significant challenges and opportunities, and propose recommendations for the future. Elements noted to be associated with successful healthcare quality improvement efforts include the presence of physician leadership, infrastructural support, and prioritization of healthcare quality within the culture of the organization. Issues that will require continued work include the development of a valid and reliable evidence base, accurate and replicable performance measurement and data collection methods, and development of a standard set of specialty specific performance metrics, with accurate provider attribution, risk adjustment and reporting mechanisms.
当前的医疗保健质量改进基础设施是一个世纪以来积累努力的产物。它始于对医疗保健质量的作用的认可，并逐渐发展到包括质量改进的优先级、建立系统以监测、量化和激励医疗保健质量改进。我们回顾了美国医疗保健质量运动的起源和演变，确定了肌肉骨骼护理的现有举措，概述了重大挑战和机遇，并为未来提出了建议。与成功的医疗保健质量改进努力相关的要素包括医生领导力的存在、基础设施支持以及组织文化中对医疗保健质量的重视。需要继续努力的问题包括开发有效的和可靠的证据基础、准确和可复制的绩效衡量和数据收集方法，以及开发一套具有准确提供者归属、风险调整和报告机制的专业特定绩效指标的标准。
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