Talsma AkkeNeel, McLaughlin Margaret, Bathish Melissa, Sirihorachai Rattima, Kuttner Rafael
University of Michigan, Ann Arbor, USA
University of Michigan, Ann Arbor, USA.
West J Nurs Res. 2014 Aug;36(7):929-46. doi: 10.1177/0193945914537121. Epub 2014 Jun 2.
Major efforts have been directed toward the implementation of sustainable quality improvement. To date, progress has been noted using various metrics and performance measures; however, successful implementation has proven challenging. The Quality, Implementation, and Evaluation (QIE) model, derived from Donabedian's structure component, presents a framework for implementation of specific activities. The QIE model consists of Policy, Patient Preparedness, Provider Competency, and Performance and Accountability, to guide specific practice initiatives. The implementation of alcohol-based pre-operative skin prep was evaluated in a sample of 17 hospitals and demonstrated that hospitals actively engaged in the components of the model demonstrated a significantly higher use of alcohol-based skin preparation agent than hospitals that did not engage in QIE model activities. The QIE model presents a powerful and actionable implementation model for mid-level management and clinical leadership. Future studies will further evaluate the impact of the specific components of the QIE model.
主要工作都致力于实现可持续的质量改进。迄今为止，已通过各种指标和绩效衡量方法取得了进展；然而，事实证明成功实施具有挑战性。源自唐纳贝迪安结构要素的质量、实施与评估（QIE）模型，为具体活动的实施提供了一个框架。QIE模型由政策、患者准备情况、提供者能力以及绩效与问责制组成，以指导具体的实践举措。在17家医院的样本中对基于酒精的术前皮肤准备的实施情况进行了评估，结果表明，积极参与该模型各要素的医院使用基于酒精的皮肤准备剂的比例明显高于未参与QIE模型活动的医院。QIE模型为中层管理和临床领导提供了一个强大且可操作的实施模型。未来的研究将进一步评估QIE模型具体要素的影响。
