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[门诊肿瘤护理质量指标常规调查的反馈策略]

[Feedback strategies for routine surveys of quality indicators in outpatient oncology care].

作者信息

Klein Astrid, Hermes-Moll Kerstin, Osburg Sandra, Walawgo Thomas, Mödder Martin, Baumann Walter

机构信息

Wissenschaftliches Institut der Niedergelassenen Hämatologen und Onkologen (WINHO) GmbH, Köln, Deutschland.

Wissenschaftliches Institut der Niedergelassenen Hämatologen und Onkologen (WINHO) GmbH, Köln, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2018 Jul;134:18-26. doi: 10.1016/j.zefq.2017.12.001. Epub 2018 Feb 7.

Abstract

OBJECTIVES

The study deals with the efficiency and possible improvements of quality promotion with quality indicators (QI). The goal is to investigate the practical use of feedback from QI surveys in the field of oncology office practices. It captures both the acceptance of results and the independent initiation of search- and improvement strategies. The value of best practice examples is of further interest.

METHODS

Within one year, data of six QI of 31 physicians from 24 oncology practices were collected twice and the results were sent back in individual reports including a benchmarking. Practices with particularly good results in individual QI sectors were surveyed in semi-structured telephone interviews about their processes. Based on these results, best practice examples were created and provided to all participating practices to stimulate improvement. Further, two paper-based surveys about the acceptance and handling of results as well as the use of best practice examples were conducted.

RESULTS

The practices accepted the reported results as an instrument to assess their own care quality (70 %) and indicated that had been able to identify improvement potentials (75 %). Improvement strategies were developed or planned by approximately every second practice in the respective sectors. The practices were interested in the best practice examples and rated them as helpful (70 %). Many of them indicated that they were already taking up some of the suggestions for improving the organization of their own processes or were planning to do so.

CONCLUSION

The extraction of information on QI from patient files is a tedious task for the practices. Both the implementation of the necessary internal measures after receiving the results report as well as the adaptation of external process examples to their own processes is challenging. Nevertheless, oncology practices benefit from the feedback of the results of QI surveys and best practice examples. Thus, QI surveys and the reporting of results can actively encourage quality development.

摘要

目的

本研究探讨使用质量指标(QI)促进质量提升的效率及可能的改进措施。目标是调查QI调查反馈在肿瘤诊疗实践领域的实际应用情况。研究涵盖了对结果的接受程度以及自主启动的探索和改进策略。最佳实践案例的价值也备受关注。

方法

在一年内,对来自24家肿瘤诊疗机构的31名医生的6项QI数据进行了两次收集,并将结果以包含基准比较的个人报告形式反馈回去。对在个别QI领域取得特别好成绩的诊疗机构进行了半结构化电话访谈,了解其流程。基于这些结果,创建了最佳实践案例并提供给所有参与的诊疗机构以促进改进。此外,还进行了两项关于结果接受和处理以及最佳实践案例使用情况的纸质调查。

结果

诊疗机构将报告的结果视为评估自身医疗质量的一种工具(70%),并表示能够识别改进潜力(75%)。在各个领域,大约每两个诊疗机构中就有一个制定或计划制定改进策略。诊疗机构对最佳实践案例感兴趣,并认为它们很有帮助(70%)。许多机构表示,他们已经在采纳一些改进自身流程组织的建议,或者计划这样做。

结论

从患者档案中提取QI信息对诊疗机构来说是一项繁琐的任务。在收到结果报告后实施必要的内部措施以及使外部流程示例适应自身流程都具有挑战性。尽管如此,肿瘤诊疗机构仍能从QI调查结果反馈和最佳实践案例中受益。因此,QI调查和结果报告可以积极推动质量发展。

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