Rizzi Franco, Pizzuto Massimo, Lodetti Laura, Corli Oscar, Da Col Daria, Damiani Maria Eugenia, Mihali Dorian, Piva Laura, Saita Luigi, Vinci Maria, Bonaldi Antonio
Istituti Clinici di Perfezionamento Hospital, Milan, Italy.
BMJ Support Palliat Care. 2012 Mar;2(1):57-62. doi: 10.1136/bmjspcare.d4920rep.
Assessing the quality of care and service delivery through the analysis of ad hoc indicators is a relevant process for quality monitoring and improvement with a view to providing patients, the community and administrators alike with appropriate elements of evaluation. This paper describes the key results of a certification process based on the Joint Commission International (JCI) criteria for the home hospitalisation model implemented by the palliative care units of seven Milan hospitals for terminally ill patients with cancer.
In 2006, the interhospital working team implemented a certification project based on the JCI Disease or Condition-Specific Care (DSCS) programme. Thirty standards subdivided into five functional areas with 150 measurable elements were the starting-point for periodic improvement plans within and across participating hospitals. Programme compliance was analysed in terms of annual performance improvement and consistency across the seven PCUs involved in achieving set goals. The JCI standards were applied on 3316 terminally ill patients with cancer treated at home from 2005 to 2009.
As a result of the work carried out, the JCI survey conducted 3 years after project implementation demonstrated full compliance with the established standards, leading to the JCI certification award (for the first time in this clinical setting internationally).
The work carried out with a view to certification has confirmed the possibility that facilities spread across different hospitals can actually share common processes and standardise the activities for the care of end-of-life patients with cancer at home as if they were one single service provider.
通过分析特定指标来评估护理和服务质量是质量监测与改进的一个相关过程，旨在为患者、社区和管理人员提供适当的评估要素。本文描述了一项认证过程的关键结果，该认证过程基于国际联合委员会（JCI）标准，针对米兰七家医院的姑息治疗科为晚期癌症患者实施的居家住院模式。
2006年，医院间工作团队实施了一项基于JCI特定疾病或状况护理（DSCS）计划的认证项目。30项标准分为五个功能领域，包含150个可衡量要素，是参与医院内部及之间定期改进计划的起点。根据年度绩效改进情况以及参与实现既定目标的七个姑息治疗科之间的一致性，对项目合规情况进行了分析。JCI标准应用于2005年至2009年在家接受治疗的3316例晚期癌症患者。
由于所开展的工作，在项目实施3年后进行的JCI调查显示完全符合既定标准，从而获得了JCI认证奖项（在国际上该临床环境中尚属首次）。
为获得认证而开展的工作证实，分布在不同医院的机构实际上有可能共享共同流程，并将居家照顾晚期癌症患者的活动标准化，就好像它们是一个单一的服务提供者一样。
