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认证维持:实践中的绩效变化如何改善成瘾精神科医生实践中的戒烟情况。

Maintenance of certification: How performance in practice changes improve tobacco cessation in addiction psychiatrists' practice.

作者信息

Ford James H, Oliver Karen A, Giles Miriam, Cates-Wessel Kathryn, Krahn Dean, Levin Frances R

机构信息

University of Wisconsin-Madison, Madison, Wisconsin.

American Academy of Addiction Psychiatry, Providence, Rhode Island.

出版信息

Am J Addict. 2017 Jan;26(1):34-41. doi: 10.1111/ajad.12480. Epub 2016 Dec 14.

Abstract

BACKGROUND AND OBJECTIVES

In 2000, the American Board of Medical Specialties implemented the Maintenance of Certification (MOC), a structured process to help physicians identify and implement a quality improvement project to improve patient care. This study reports on findings from an MOC Performance in Practice (PIP) module designed and evaluated by addiction psychiatrists who are members of the American Academy of Addiction Psychiatry (AAAP).

METHOD

A 3-phase process was utilized to recruit AAAP members to participate in the study. The current study utilized data from 154 self-selected AAAP members who evaluated the effectiveness of the MOC Tobacco Cessation PIP.

RESULTS

Of the physicians participating, 76% (n = 120) completed the Tobacco PIP. A paired t-test analysis revealed that reported changes in clinical measure documentation were significant across all six measures. Targeted improvement efforts focused on a single clinical measure. Results found that simple change projects designed to improve clinical practice led to substantial changes in self-reported chart documentation for the selected measure.

CONCLUSIONS

The current findings suggest that addiction psychiatrists can leverage the MOC process to improve clinical care.

SCIENTIFIC SIGNIFICANCE

The study demonstrates that a quality improvement collaborative can support an MOC process to help addiction psychiatrists eliminate barriers to access to tobacco cessation treatment. (Am J Addict 2017;26:34-41).

摘要

背景与目的

2000年,美国医学专业委员会实施了认证维持计划(MOC),这是一个结构化流程,旨在帮助医生识别并实施质量改进项目以改善患者护理。本研究报告了由美国成瘾精神病学会(AAAP)成员中的成瘾精神病医生设计并评估的MOC实践表现(PIP)模块的研究结果。

方法

采用三阶段流程招募AAAP成员参与研究。本研究使用了154名自行选择的AAAP成员的数据,他们评估了MOC戒烟PIP的有效性。

结果

参与研究的医生中,76%(n = 120)完成了烟草PIP。配对t检验分析显示,所有六项临床指标的报告变化均具有显著性。有针对性的改进工作集中在单一临床指标上。结果发现,旨在改善临床实践的简单变革项目导致所选指标的自我报告图表记录有实质性变化。

结论

当前研究结果表明,成瘾精神病医生可利用MOC流程改善临床护理。

科学意义

该研究表明,质量改进协作可为MOC流程提供支持,以帮助成瘾精神病医生消除戒烟治疗获取方面的障碍。(《美国成瘾杂志》2017年;26:34 - 41)

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