Medical Director CQI and Clinical Research, Women and Children's Services, Providence St. Joseph Health System, 9205 SW Barnes Road, Portland, OR, 97225, USA.
Professor of Pediatrics, Baylor College of Medicine, Section Head and Service Chief of Neonatology, Texas Children's Hospital, 6621 Fannin, Suite W6104, Houston, TX, 77030, USA.
J Perinatol. 2019 Apr;39(4):588-592. doi: 10.1038/s41372-019-0330-0. Epub 2019 Feb 5.
Quality improvement (QI) and evidence-based medicine (EBM) activities ideally generate value (benefit/cost). Physicians and hospitals vary in ability to demonstrate efficiency despite common methodology available to all. Based upon our 60-some years of combined QI and EBM experience, we suggest reasoned consideration of meta-cognition-thinking about thinking. How do we observe, analyze, intuit, then share observations and learning with collaborative networks? The Greek word aletheia denotes disclosure of the essence of an object or event as its genuine nature, "unhidden, revealed, unconcealed". Aletheia is authenticity, not a claim or opinion, not an argument or hypothesis, nor an intervention-based assertion. QI and EBM have crucial features obscured by the lure and distraction of technology, economic conflicts, and inherent self-interests. We offer 20 QI and EBM observations in the spirit of aletheia. Enhancing the well-being of children is the foundation of a civilized society, a journey needful of shared QI understanding.
质量改进（QI）和循证医学（EBM）活动理想情况下会产生价值（收益/成本）。尽管所有医生和医院都可以使用共同的方法，但他们在展示效率方面的能力却存在差异。基于我们 60 多年来积累的 QI 和 EBM 经验，我们建议对元认知进行理性思考——思考如何观察、分析、凭直觉判断，然后与协作网络共享观察结果和学习。希腊词 aletheia 表示揭示事物或事件的本质，即其真实性质，“不隐藏、不揭示、不隐瞒”。Aletheia 是真实性，而不是主张或意见，不是论证或假设，也不是基于干预的断言。QI 和 EBM 具有关键特征，但被技术的诱惑和干扰、经济冲突和内在的自身利益所掩盖。我们本着 aletheia 的精神提供了 20 个 QI 和 EBM 观察结果。提高儿童的福祉是文明社会的基础，这是一个需要共同理解 QI 的旅程。
