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[《优质医学倡议》中的五年同行评审]

[Five years of peer reviewing in the Quality Medicine Initiative].

作者信息

Eberlein-Gonska Maria, Budic Anita, Winklmair Claudia, Petzold Thomas

机构信息

Zentralbereich Qualitäts- und Medizinisches Risikomanagement, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland.

Initiative Qualitätsmedizin, Geschäftsstelle.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2015;109(9-10):650-9. doi: 10.1016/j.zefq.2015.09.027. Epub 2015 Nov 20.

Abstract

OBJECTIVE

Peer review focuses on critical self-reflection, especially of physicians in direct contact and dialogue with other disciplines and professional groups. The main purpose of the peer review is the principle of self-determination, the intention to learn from each other more effectively, and a commitment to quality improvement. During the past five years the Quality in Medicine Initiative (IQM) has successfully promotes peer reviewing in German-speaking areas. The aim of this study is to investigate all records of IQM peer reviews and to outline the results in the course of development. The major focuses include medical aspects for improvement, information concerning organizational processes and the satisfaction of the visited hospitals.

METHOD

A systematic descriptive analysis of all records as well as feedback sheets was conducted between 2010 and 2014.

RESULTS

294 of 304 planned peer reviews were considered, involving among different hospital owners and different clinical conditions. The identified potential for improvement of the peer team was higher than that of the physicians of the hospitals visited. The assessment of the medical review criteria illustrates the following different trends: a positive development occurred concerning the appropriate and timely diagnostic and treatment; a clear potential for improvement could be established concerning a complete and conclusive documentation. Regarding the clinical conditions, anomalies were identified which are important for all IQM hospitals. As regards sustainability, first results from so-called re-reviews were available and provided important information pointing in the direction of structure and process improvement. The satisfaction of the visited physicians increased continuously within these five years.

CONCLUSION

In the light of all data records and satisfaction sheets, the IQM peer review has become well-established over the last five years. Possible reasons are a well-defined framework, clear structures and different kinds of support. The success of the cooperation of the German Medical Association and IQM is illustrated by the development of the curriculum peer review. Re-reviews provide impulses for sustainability. At any rate, there is a need for scientific evaluation of the peer review method in order to generate evidence for this important tool of quality improvement.

摘要

目的

同行评审侧重于批判性的自我反思,尤其是对于那些与其他学科和专业团体直接接触并进行对话的医生。同行评审的主要目的是自主原则、更有效地相互学习的意愿以及对质量改进的承诺。在过去五年中,医学质量倡议(IQM)已在德语区成功推动了同行评审。本研究的目的是调查IQM同行评审的所有记录,并概述其发展过程中的结果。主要重点包括有待改进的医学方面、有关组织流程的信息以及受访医院的满意度。

方法

对2010年至2014年期间的所有记录以及反馈表进行了系统的描述性分析。

结果

在计划的304次同行评审中,有294次得到了考虑,涉及不同的医院所有者和不同的临床情况。同行评审团队确定的改进潜力高于受访医院的医生。医学评审标准的评估显示出以下不同趋势:在适当和及时的诊断与治疗方面出现了积极发展;在完整和确凿的文档记录方面可以确定明显的改进潜力。关于临床情况,发现了对所有IQM医院都很重要的异常情况。关于可持续性,所谓的重新评审得出了初步结果,并提供了指向结构和流程改进方向的重要信息。在这五年中,受访医生的满意度持续提高。

结论

根据所有数据记录和满意度表,IQM同行评审在过去五年中已确立了稳固地位。可能的原因是有明确界定的框架、清晰的结构和各种支持。课程同行评审的发展说明了德国医学协会与IQM合作的成功。重新评审为可持续性提供了动力。无论如何,需要对同行评审方法进行科学评估,以便为这一重要的质量改进工具提供证据。

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