The Israeli Medical Association (IMA), Ramat Gan, Israel.
Isr J Health Policy Res. 2014 Apr 25;3:14. doi: 10.1186/2045-4015-3-14. eCollection 2014.
Many countries have devoted considerable efforts in an attempt to improve the performance of their health care systems. National Medical Associations (NMAs), along with other stakeholders, play a part in the promotion of such activities. The purpose of this paper is to explore the nature and level of participation of NMAs in activities of quality improvement in medicine, with a specific emphasis on Israel.
THE AUTHORS CONDUCTED A SURVEY AMONG NMAS AROUND THE WORLD INQUIRING AS TO THEIR INVOLVEMENT IN THREE CENTRAL ASPECTS OF QUALITY IMPROVEMENT: clinical guidelines, quality measurement and continuing medical education (CME). In addition, they conducted a review of the literature in order to gather more information and complete the data collected in the survey. The findings were processed and analyzed comparatively.
Most of the NMAs surveyed participate in quality improvement activities at least to some extent. NMAs' main involvement is in the regulation of CME and they are involved to a much lesser extent in the preparation of clinical guidelines and in quality measurement. In Israel, the Israeli Medical Association (IMA) has a dominant role in both the preparation of clinical guidelines and the regulation of CME credits.
It is possible that the expertise maintained by the profession, coupled with the organizational power of the NMA as a union, is viewed as beneficial for regulating educational activities in medicine such as CME. Conversely, the issuing of clinical guidelines is usually regarded as a typical scientific activity, and therefore often rests in the hands of professional medical societies. Quality measurement is regarded as a distinctive administrative tool and is usually found in the province of governments. Based on the typology that we introduced in our previous paper, we discovered that the extent of NMAs' involvement in quality improvement coincides with the mode of governance of the health care system.
The nature and level of participation of NMAs in activities of quality improvement varies widely. Collaboration of NMAs in this field with other stakeholders is not uncommon, and may contribute to the further development of quality improvement in medicine.
许多国家投入了相当大的努力，试图提高其医疗保健系统的绩效。国家医学协会（NMAs）与其他利益相关者一起，参与了此类活动的推广。本文的目的是探讨 NMAs 在医学质量改进活动中的性质和参与程度，特别是在以色列。
作者在世界各地对 NMAs 进行了一项调查，询问他们在质量改进的三个核心方面的参与情况：临床指南、质量测量和继续医学教育（CME）。此外，他们还对文献进行了回顾，以收集更多信息并补充调查中收集的数据。调查结果经过处理和分析进行比较。
大多数接受调查的 NMAs 至少在一定程度上参与了质量改进活动。NMAs 的主要参与是在 CME 的监管方面，而在临床指南的制定和质量测量方面的参与程度要低得多。在以色列，以色列医学会（IMA）在临床指南的制定和 CME 学分的监管方面都发挥着主导作用。
专业知识的专业知识，再加上 NMA 作为工会的组织权力，可能被视为有利于监管医学教育活动，如 CME。相反，临床指南的发布通常被视为一种典型的科学活动，因此通常由专业医学协会负责。质量测量被视为一种独特的管理工具，通常在政府管辖范围内。根据我们在之前的论文中引入的分类法，我们发现 NMAs 在质量改进活动中的参与程度与医疗保健系统的治理模式相符。
NMAs 在质量改进活动中的参与性质和程度差异很大。NMAs 在该领域与其他利益相关者的合作并不少见，这可能有助于医学质量改进的进一步发展。
