Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
BMJ Open. 2019 Jan 7;9(1):e023596. doi: 10.1136/bmjopen-2018-023596.
The shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality indicators that can be used to measure PCC.
Design: scoping review.
studies were identified through searching seven electronic databases and the grey literature. Search terms included quality improvement, quality indicators, healthcare quality and PCC. Eligibility Criteria: articles were included if they mentioned development and/or implementation of PC-QIs.
extracted data included study characteristics (country, year of publication and type of study/article), patients' inclusion in the development of indicators and type of patient populations and point of care if applicable (eg, in-patient, out-patient and primary care).
A total 184 full-text peer-reviewed articles were assessed for eligibility for inclusion; of these, 9 articles were included in this review. From the non-peer-reviewed literature, eight documents met the criteria for inclusion in this study. This review revealed the heterogeneity describing and defining the nature of PC-QIs. Most PC-QIs were presented as PCC measures and identified as guidelines, surveys or recommendations, and therefore cannot be classified as actual PC-QIs. Out of 502 ways to measure PCC, only 25 were considered to be actual PC-QIs. None of the identified articles implemented the quality indicators in care settings.
The identification of PC-QIs is a key first step in laying the groundwork to develop evidence-based PC-QIs. Research is needed to continue the development and implementation of PC-QIs for healthcare quality improvement.
以患者为中心的医疗模式作为一种医疗服务模式,需要进行系统的测量和评估。本研究旨在确定可用于衡量以患者为中心的质量指标(PC-QIs),旨在尝试开发以患者为中心的质量指标。
设计:范围综述。
通过搜索七个电子数据库和灰色文献确定研究。搜索词包括质量改进、质量指标、医疗保健质量和以患者为中心。纳入标准:如果文章提到了 PC-QIs 的开发和/或实施,则将其纳入。
提取的数据包括研究特征(国家、发表年份和研究/文章类型)、患者是否参与指标制定以及患者人群类型和护理点(如住院、门诊和初级保健)。
评估了 184 篇全文同行评审文章的纳入标准;其中,9 篇文章纳入本综述。从非同行评审文献中,有 8 份文件符合纳入本研究的标准。本综述揭示了描述和定义 PC-QIs 性质的异质性。大多数 PC-QIs 被作为 PCC 测量方法提出,并被确定为指南、调查或建议,因此不能被归类为实际的 PC-QIs。在 502 种测量 PCC 的方法中,只有 25 种被认为是实际的 PC-QIs。没有一篇确定的文章在护理环境中实施质量指标。
确定 PC-QIs 是为制定基于证据的 PC-QIs 奠定基础的关键第一步。需要进行研究,以继续开发和实施医疗保健质量改进的 PC-QIs。