Mathews Simon C, Pronovost Peter J, Daugherty Biddison E Lee, Petty Brent G, Anderson Mark E, Nelson Terry S, Outten Katie, Langlotz Ronald, Duda Denice, Herzke Carrie A, Peairs Kimberly S, Golden Sherita H, Lautzenheiser Matthew B, James Hailey J, Desai Sanjay V, Keller Sara C, Feldman Leonard S, Pahwa Amit K, Berry Stephen A
1 Johns Hopkins University School of Medicine, Baltimore, MD.
2 Johns Hopkins Medicine, Baltimore, MD.
Am J Med Qual. 2018 Jul;33(4):413-419. doi: 10.1177/1062860617743324. Epub 2017 Nov 28.
Payers, providers, and patients increasingly recognize the importance of quality and safety in health care. Academic Departments of Medicine can advance quality and safety given the large populations they serve and the broad spectrum of diseases they treat. However, there are only few detailed examples of how quality and safety can be organized. This article describes a practical model at The Johns Hopkins Hospital Department of Medicine and details its structure and operation within a large academic health system. It is based on a fractal model that integrates multiple smaller units similar in structure (composition of faculty/staff), process (use of similar tools), and approach (using a common framework to address issues). This organization stresses local, multidisciplinary leadership, facilitates horizontal connections for peer learning, and maintains vertical connections for broader accountability.
支付方、医疗服务提供者和患者越来越认识到医疗保健中质量和安全的重要性。医学学术部门由于服务的人群庞大且治疗的疾病种类广泛，能够推动质量和安全的提升。然而，关于如何组织质量和安全的详细示例却很少。本文介绍了约翰·霍普金斯医院医学部的一个实用模型，并详细阐述了其在大型学术医疗系统中的结构和运作。它基于一个分形模型，该模型整合了多个在结构（教职员工组成）、流程（使用类似工具）和方法（使用共同框架解决问题）上相似的较小单元。这种组织强调地方多学科领导，促进同行学习的横向联系，并保持更广泛问责制的纵向联系。
