J.-J. Koksma is philosopher and learning researcher, Radboud University Nijmegen Medical Centre Health Academy, Nijmegen, The Netherlands; ORCID: https://orcid.org/0000-0002-4682-1758. J.A.M. Kremer is gynecologist, Radboud University Nijmegen Medical Centre, Scientific Institute for Quality in Healthcare, Nijmegen, The Netherlands; ORCID: https://orcid.org/0000-0002-0495-0201.
Acad Med. 2019 Feb;94(2):166-169. doi: 10.1097/ACM.0000000000002464.
By highlighting the intangible, personal, contextual, and illusory nature of "quality," the authors reconceptualize quality improvement as a pluralistic and moral journey. They imagine a new era of quality improvement in which patients and health care providers work together to understand and achieve quality. The authors recommend, for the path forward, a "travel kit" of 10 crucial elements-compassion, deliberation, flexible goals, ownership, the engagement of patients, the inclusion of payers, the involvement of learners, feedback loops, the fostering of learning, and the application of different sources of knowledge-to reframe quality improvement in a new era of learning.
通过突出“质量”的无形、个人、背景和虚幻性质,作者将质量改进重新概念化为一个多元化和道德的旅程。他们设想了一个新的质量改进时代,在这个时代,患者和医疗保健提供者共同努力理解和实现质量。作者为未来的发展推荐了一个“旅行工具包”,其中包括 10 个关键要素——同情心、深思熟虑、灵活的目标、所有权、患者的参与、支付方的纳入、学习者的参与、反馈循环、学习的促进以及不同知识来源的应用——以在学习的新时代重新构建质量改进。