Moonesinghe S Ramani, Grocott Michael P W, Bennett-Guerrero Elliott, Bergamaschi Roberto, Gottumukkala Vijaya, Hopkins Thomas J, McCluskey Stuart, Gan Tong J, Mythen Michael Monty G, Shaw Andrew D, Miller Timothy E
UCLH NIHR Surgical Outcomes Research Centre and NIAA Health Services Research Centre, Royal College of Anaesthetists, London, UK.
Faculty of Medicine, University of Southampton, Southampton, UK.
Perioper Med (Lond). 2017 Mar 17;6:6. doi: 10.1186/s13741-017-0062-7. eCollection 2017.
This article sets out a framework for measurement of quality of care relevant to enhanced recovery pathways (ERPs) in elective colorectal surgery. The proposed framework is based on established measurement systems and/or theories, and provides an overview of the different approaches for improving clinical monitoring, and enhancing quality improvement or research in varied settings with different levels of available resources.
Using a structure-process-outcome framework, we make recommendations for three hierarchical tiers of data collection.
Core, Quality Improvement, and Best Practice datasets are proposed. The suggested datasets incorporate patient data to describe case-mix, process measures to describe delivery of enhanced recovery and clinical outcomes. The fundamental importance of routine collection of data for the initiation, maintenance, and enhancement of enhanced recovery pathways is emphasized.
本文提出了一个用于衡量与择期结直肠癌手术强化康复路径(ERP)相关的医疗质量的框架。该提议的框架基于既定的测量系统和/或理论,并概述了在不同资源可用水平的各种环境中改善临床监测以及加强质量改进或研究的不同方法。
使用结构-过程-结果框架,我们对三个层次的数据收集提出建议。
提出了核心、质量改进和最佳实践数据集。建议的数据集纳入患者数据以描述病例组合、过程指标以描述强化康复的实施情况以及临床结果。强调了常规收集数据对于启动、维持和加强强化康复路径的根本重要性。