Luckenbaugh Amy N, Miller David C, Ghani Khurshid R
Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Curr Opin Urol. 2017 Jul;27(4):395-401. doi: 10.1097/MOU.0000000000000404.
Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care.
Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes. The largest regional collaborative in urology is the Michigan Urological Surgery Improvement Collaborative (MUSIC). Recent efforts by this group have been focused at understanding variation in care, improving patient selection for treatment, reducing treatment morbidity and measuring and optimizing technical skill. The American Urological Association has also recently launched a national quality registry (AQUA), with an initial focus on prostate cancer care.
By understanding factors that result in exemplary performance, quality improvement collaboratives are able to develop best practices around areas of care with high variation that have the potential to improve outcomes and reduce costs. These developments have been made possible by the unique model offered by the collaborative structure with the goal of improving patient care at a population level.
质量改进协作组织在许多医学和外科学科中得以发展，目的是衡量并提高为患者提供的医疗服务质量。本综述旨在概述外科质量改进协作组织，尤其是那些旨在改善泌尿外科护理的组织。
质量改进协作组织采用标准化方法收集高质量数据，并利用这些数据向医生和医疗机构提供反馈，然后实施相关流程以改善患者预后。泌尿外科领域最大的区域协作组织是密歇根泌尿外科手术改进协作组织（MUSIC）。该组织近期的工作重点是了解护理差异、改善治疗的患者选择、降低治疗发病率以及衡量和优化技术技能。美国泌尿外科协会最近还推出了一个全国性质量登记系统（AQUA），初期重点关注前列腺癌护理。
通过了解促成卓越表现的因素，质量改进协作组织能够围绕护理差异较大且有可能改善预后和降低成本的领域制定最佳实践方案。协作结构所提供的独特模式使得在人群层面改善患者护理成为可能，从而实现了这些进展。
