一种利用新型门诊手术协调委员会将门诊手术中心整合到学术健康系统中的模式。

A Model for Integrating Ambulatory Surgery Centers Into an Academic Health System Using a Novel Ambulatory Surgery Coordinating Council.

作者信息

Ishii Lisa, Pronovost Peter J, Demski Renee, Wylie Gill, Zenilman Michael

机构信息

L. Ishii is chief quality officer for clinical best practices, Johns Hopkins Health System, medical director for clinical integration, Office of Johns Hopkins Physicians, and associate professor, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. P.J. Pronovost is senior vice president for patient safety and quality and director, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, and professor of anesthesiology and critical care medicine, surgery, and health policy and management, Johns Hopkins University School of Medicine, Baltimore, Maryland. R. Demski is vice president of quality, Johns Hopkins Health System and Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland. G. Wylie is executive director, Johns Hopkins Medical Management, Johns Hopkins Health System, Baltimore, Maryland. M. Zenilman is chief quality officer for ambulatory surgery and professor, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

Acad Med. 2016 Jun;91(6):803-6. doi: 10.1097/ACM.0000000000001135.

DOI:10.1097/ACM.0000000000001135

PMID:26934690

Abstract

PROBLEM

An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations.

APPROACH

Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs.

OUTCOMES

Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies.

NEXT STEPS

The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.

摘要

问题

门诊手术量的不断增加导致了门诊手术中心（ASC）数量的增多。一些学术医疗系统已与门诊手术中心联合起来，以创建一个更加整合的医疗服务提供系统。然而，这些中心在许多方面存在差异，包括专科类型、所有权模式、管理、医生聘用以及监管监督等。学术医疗系统在将这些门诊手术中心整合到其组织中时面临挑战。

方法

约翰·霍普金斯医学中心于2014年成立了门诊手术协调委员会，以管理、规范并促进其八个门诊手术中心之间的同行学习。阿姆斯特朗患者安全与质量研究所通过其质量管理基础设施为该组织提供支持并树立了典范。由医生主导的委员会明确了使命并制定了目标，以确定最佳实践，统一提供以患者为中心的最高质量护理，并持续改善各门诊手术中心的患者治疗效果和就医体验。