Marshall Deborah A, Christiansen Tanya, Smith Christopher, Squire Howden Jane, Werle Jason, Faris Peter, Frank Cy
University of Calgary, Calgary, Alberta, Canada Alberta Bone and Joint Health Institute, Calgary, Alberta, Canada
Alberta Bone and Joint Health Institute, Calgary, Alberta, Canada.
Am J Med Qual. 2015 Sep-Oct;30(5):425-31. doi: 10.1177/1062860614540512. Epub 2014 Jun 23.
Improving quality of care and maximizing efficiency are priorities in hip and knee replacement, where surgical demand and costs increase as the population ages. The authors describe the integrated structure and processes from the Continuous Quality Improvement (CQI) Program for Hip and Knee Replacement Surgical Care and summarize lessons learned from implementation. The Triple Aim framework and 6 dimensions of quality care are overarching constructs of the CQI program. A validated, evidence-based clinical pathway that measures quality across the continuum of care was adopted. Working collaboratively, multidisciplinary experts embedded the CQI program into everyday practices in clinics across Alberta. Currently, 83% of surgeons participate in the CQI program, representing 95% of the total volume of hip and knee surgeries. Biannual reports provide feedback to improve care processes, infrastructure planning, and patient outcomes. CQI programs evaluating health care services inform choices to optimize care and improve efficiencies through continuous knowledge translation.
提高护理质量和实现效率最大化是髋关节和膝关节置换手术的首要任务，随着人口老龄化，手术需求和成本不断增加。作者描述了髋关节和膝关节置换手术护理持续质量改进（CQI）计划的综合结构和流程，并总结了实施过程中的经验教训。三重目标框架和护理质量的六个维度是CQI计划的总体架构。采用了一个经过验证的、基于证据的临床路径，以衡量整个护理过程中的质量。多学科专家通过合作，将CQI计划融入艾伯塔省各地诊所的日常实践中。目前，83%的外科医生参与了CQI计划，占髋关节和膝关节手术总量的95%。半年报告提供反馈，以改进护理流程、基础设施规划和患者治疗效果。评估医疗服务的CQI计划通过持续的知识转化，为优化护理和提高效率的选择提供信息。
