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麻醉学中的比较绩效报告:对临床结果的影响及临床医生的可接受性。

Comparative performance reports in anaesthesia: impact on clinical outcomes and acceptability to clinicians.

作者信息

Collyer Thomas, Robertson Martyn, Lawton Thomas, Rothwell Alice

机构信息

Department of Anaesthesia and Intensive Care Medicine, Harrogate and District NHS Foundation Trust, Harrogate, North Yorkshire, UK.

Department of Anaesthesia and Intensive Care Medicine, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.

出版信息

BMJ Open Qual. 2018 Jul 21;7(3):e000338. doi: 10.1136/bmjoq-2018-000338. eCollection 2018.

Abstract

In anaesthesia, the use of comparative performance reports, their impact on patient care and their acceptability is yet to be fully clarified. Since April 2010, postoperative data on theatre cases in our trust have been analysed and individual comparative performance reports distributed to anaesthetists. Our primary aim was to investigate whether this process was associated with improvement in overall patient care. A short survey was used to assess our secondary aim, the usefulness and acceptability of the process. There were significant improvements in the odds of all outcomes other than vomiting: 39% improvement in hypothermia (p<0.001); 9.9% improvement in severe pain (p<0.001%); 9.6% improvement in moderate pain (p<0.001); 5.3% improvement in percentage pain free (p=0.04); 9.7% improvement in nausea (p=0.02); 30% improvement in unexpected admissions (p=0.001). 100% of consultant respondents agreed that performance reports prompted reflective practice and that this process had the potential to improve patient care. The provision of comparative performance reports was thus associated with an improvement in outcomes while remaining acceptable to the anaesthetists involved.

摘要

在麻醉领域,比较绩效报告的使用、其对患者护理的影响以及可接受性尚未完全明确。自2010年4月以来,我们信托机构对手术室病例的术后数据进行了分析,并向麻醉医生分发了个人比较绩效报告。我们的主要目的是调查这一过程是否与整体患者护理的改善相关。通过一项简短调查来评估我们的次要目的,即该过程的有用性和可接受性。除呕吐外,所有结果的几率均有显著改善:体温过低改善了39%(p<0.001);重度疼痛改善了9.9%(p<0.001%);中度疼痛改善了9.6%(p<0.001);无痛百分比改善了5.3%(p=0.04);恶心改善了9.7%(p=0.02);意外入院改善了30%(p=0.001)。100%的顾问受访者同意绩效报告促使了反思性实践,并且这一过程有改善患者护理的潜力。因此,提供比较绩效报告与结果改善相关,同时仍为相关麻醉医生所接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c2/6059265/6cf15bb0bc9d/bmjoq-2018-000338f01.jpg

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