Frush Karen, Chamness Cynthia, Olson Barbara, Hyde Sandi, Nordlund Cynthia, Phillips Harry, Holman Russell
Jt Comm J Qual Patient Saf. 2018 Jul;44(7):389-400. doi: 10.1016/j.jcjq.2018.04.008. Epub 2018 Jun 6.
Through an innovative affiliation, Duke University Health System (DUHS), a large and complex academic health system, and LifePoint Health® (LifePoint [LP]) collaborated to create a joint venture, DLP Healthcare (DLP) to measurably improve culture and quality and patient safety metrics in community hospitals across the United States. A structured approach to quality was developed in DLP hospitals and later refined and spread to all LP hospitals through the National Quality Program (NQP).
The NQP was designed to drive organizationwide performance improvement through use of a framework of leadership, performance improvement, and culture. A comprehensive quality assessment of each DLP and LP hospital led to the creation of a customized improvement plan that was specific to the performance level of individual hospitals and aligned with strategic organizational goals. The improvement process was data driven, managed with defined improvement methodologies and practices, and implemented in a culture that honors teamwork, mutual respect, accountability and provider well-being.
Implementation of the NQP has led to significant improvements in patient safety metrics and in safety culture, which have now been sustained for more than seven years. Aggregate harm, as measured by administrative claims data-based harms per 1,000 inpatient-days, was reduced by 62.5% between January 2011 and December 2017, as compared to 2010 baseline data.
The LP and Duke journey to achieve high reliability in community hospitals has yielded significant improvement in measures of patient safety and culture. The results are consistent with literature supporting the link between culture and overall performance.
通过一项创新合作关系，大型复杂的学术医疗系统杜克大学健康系统（DUHS）与生命点健康公司（LifePoint [LP]）合作成立了一家合资企业，即DLP医疗保健公司（DLP），以显著改善美国社区医院的文化、质量和患者安全指标。DLP医院制定了一种结构化的质量方法，随后通过国家质量计划（NQP）进行完善并推广至所有LP医院。
NQP旨在通过运用领导力、绩效改进和文化框架推动全组织的绩效提升。对每家DLP和LP医院进行全面质量评估后，制定了针对各医院绩效水平且与组织战略目标相一致的定制化改进计划。改进过程以数据为驱动，采用既定的改进方法和实践进行管理，并在崇尚团队合作、相互尊重、问责制和医护人员福祉的文化氛围中实施。
NQP的实施已使患者安全指标和安全文化得到显著改善，且这种改善已持续七年多。与2010年基线数据相比，2011年1月至2017年12月期间，以基于行政索赔数据的每1000住院日伤害率衡量的总体伤害减少了62.5%。
LP和杜克大学在社区医院实现高可靠性的历程已使患者安全和文化指标得到显著改善。这些结果与支持文化与整体绩效之间联系的文献一致。
