Callahan Kathryn E, Rogers Matthew T, Lovato James F, Fernandez Helen M
a Section on Gerontology and Geriatric Medicine, Department of Internal Medicine; and Clinical Geriatrics Fellowship , Sticht Center on Aging, Wake Forest School of Medicine , Winston-Salem , North Carolina , USA.
Gerontol Geriatr Educ. 2013;34(4):372-92. doi: 10.1080/02701960.2013.815179. Epub 2013 Aug 25.
Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and evaluated a QI curriculum for geriatrics fellows. The evidence-based curriculum included didactics and a fellow-led QI intervention based on audit and feedback through the Practice Improvement Module in Care of the Vulnerable Elderly. QI knowledge, attitudes, and behaviors were assessed before and after the improvement project. Fellows' knowledge of QI improved (p = .0156), but behavior did not change significantly across a short-term improvement project. A structured focus group with fellows revealed themes of accountability and the importance of interprofessional teamwork in QI. QI education for geriatrics fellows can be feasible, well received, and prepare future physician leaders for patient-centered care, performance measurement, and effecting systems change.
质量改进(QI)举措对于更易受到不合格护理影响的老年人护理至关重要。QI教育满足毕业后医学教育认证委员会核心能力的多个方面,并使学习者为医疗保健中日益关注的绩效评估做好准备。作者开发、实施并评估了一项针对老年医学研究员的QI课程。该循证课程包括教学内容以及一项由研究员主导的QI干预措施,该干预措施基于通过“弱势老年人护理实践改进模块”进行的审核与反馈。在改进项目前后对QI知识、态度和行为进行了评估。研究员的QI知识有所提高(p = 0.0156),但在短期改进项目中行为没有显著变化。与研究员进行的结构化焦点小组讨论揭示了问责制主题以及跨专业团队合作在QI中的重要性。针对老年医学研究员的QI教育可以是可行的、受到广泛欢迎的,并能让未来的医师领导者为以患者为中心的护理、绩效评估以及实现系统变革做好准备。