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制定配备医师的紧急医疗服务质量指标：一个共识达成过程。

Developing quality indicators for physician-staffed emergency medical services: a consensus process.

作者信息

Haugland Helge, Rehn Marius, Klepstad Pål, Krüger Andreas

机构信息

Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway.

Department of Emergency Medicine and Pre-Hospital Services, St. Olavs Hospital, Trondheim, Norway.

出版信息

Scand J Trauma Resusc Emerg Med. 2017 Feb 15;25(1):14. doi: 10.1186/s13049-017-0362-4.

DOI:10.1186/s13049-017-0362-4
PMID:28202076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5311851/
Abstract

BACKGROUND

There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives.

METHODS

A four-step modified nominal group technique process (expert panel method) was used.

RESULTS

The expert panel reached consensus on 26 quality indicators for P-EMS. Fifteen quality indicators measure quality of P-EMS responses (response-specific quality indicators), whereas eleven quality indicators measure quality of P-EMS system structures (system-specific quality indicators).

DISCUSSION

When measuring quality, the six quality dimensions defined by The Institute of Medicine should be appraised. We argue that this multidimensional approach to quality measurement seems particularly reasonable for services with a highly heterogenic patient population and complex operational contexts, like P-EMS. The quality indicators in this study were developed to represent a broad and comprehensive approach to quality measurement of P-EMS.

CONCLUSIONS

The expert panel successfully developed a set of quality indicators for international P-EMS. The quality indicators should be prospectively tested for feasibility, validity and reliability in clinical datasets. The quality indicators should then allow for adjusted quality measurement across different P-EMS systems.

摘要

背景

医疗服务质量测量受到越来越多的关注，其中包括院前急救医疗服务（EMS）。然而，衡量配备医生的EMS（P-EMS）质量的尝试却很少。本研究的目的是为国际P-EMS制定一套质量指标，以推动质量改进举措。

方法

采用四步改良名义小组技术流程（专家小组法）。

结果

专家小组就P-EMS的26项质量指标达成共识。15项质量指标衡量P-EMS响应的质量（特定响应质量指标），而11项质量指标衡量P-EMS系统结构的质量（特定系统质量指标）。

讨论

在测量质量时，应评估医学研究所定义的六个质量维度。我们认为，这种多维度的质量测量方法对于像P-EMS这样患者群体高度异质性且操作环境复杂的服务来说似乎特别合理。本研究中的质量指标旨在代表一种广泛而全面的P-EMS质量测量方法。

结论

专家小组成功地为国际P-EMS制定了一套质量指标。这些质量指标应在临床数据集中进行前瞻性测试，以检验其可行性、有效性和可靠性。然后，这些质量指标应允许对不同的P-EMS系统进行调整后的质量测量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f97/5311851/3c887441818b/13049_2017_362_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f97/5311851/3c887441818b/13049_2017_362_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f97/5311851/3c887441818b/13049_2017_362_Fig1_HTML.jpg

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