Fawcett Christopher, Moriarty Helen, Perera Roshan
Horowhenua Community Practice, 62 Liverpool Street, PO Box 50, Levin 5540, New Zealand. Email:
Aust Health Rev. 2013 Sep;37(4):535-40. doi: 10.1071/AH12036.
This paper demonstrates the use of a Quality Framework and Implementation Template to review processes for improving the quality and safety of opiate prescribing for chronic non-malignant pain (CNMP). Escalating use of prescription opiates for chronic pain is of national and international concern, with major implications for personal and public health as well as for patient safety and health service quality and safety.
This paper uses opiate prescribing for CNMP as a worked example to illustrate use of the Quality Framework for self-directed quality improvement in smaller specialist medical or community-based practices.
An Implementation Template, comprising a series of focussed questions derived from the Quality Framework, was applied to one specific quality improvement activity arising from clinical practice (opiate prescribing for CNMP). This helped the practice team understand current systems and processes, identify actual and potential problems, and find possible solutions to institute interventions for change.
The template approach to quality activity is very applicable within smaller specialist or community health service settings, enabling such health services to focus on their own quality improvement activities and address topics of importance to the practice in a systematic and productive manner.
本文展示了如何使用质量框架和实施模板来审查改善慢性非恶性疼痛（CNMP）阿片类药物处方质量和安全性的流程。用于慢性疼痛的处方阿片类药物的使用不断增加，这是一个国内外都关注的问题，对个人和公众健康以及患者安全和医疗服务质量与安全都有重大影响。
本文以用于CNMP的阿片类药物处方为例，说明在较小的专科医疗或社区医疗实践中如何使用质量框架进行自我导向的质量改进。
一个实施模板，包含一系列从质量框架衍生而来的重点问题，被应用于一项源于临床实践的特定质量改进活动（CNMP的阿片类药物处方）。这有助于实践团队了解当前的系统和流程，识别实际和潜在问题，并找到可能的解决方案以制定变革干预措施。
质量活动的模板方法在较小的专科或社区卫生服务环境中非常适用，使这些卫生服务能够专注于自身的质量改进活动，并以系统且富有成效的方式解决对实践至关重要的问题。
