Pronovost Peter J, Mathews Simon C, Chute Christopher G, Rosen Antony
Johns Hopkins University Baltimore Maryland.
Learn Health Syst. 2016 Dec 15;1(1):e10018. doi: 10.1002/lrh2.10018. eCollection 2017 Jan.
Health care has often relied on independent silos of medical research to drive progress and innovation. However, this approach does not adequately address the complexities and opportunities within the modern health care environment. We posit that creating a learning and improving health system that is purpose-driven will ultimately lead the next transformation in health care. We share the experience within Johns Hopkins Medicine that established a learning and improving health system in quality and safety. The system is built around a clear and compelling patient-centered purpose and leverages a fractal framework that provides horizontal links for peer learning and vertical links for accountability. It dismantles traditional research and clinical silos and combines basic and applied research with health system operations. As a result, the system aligns the goals and strengths of a diverse set of stakeholders including clinicians, patients, researchers, and administrators toward a common goal.
医疗保健常常依赖于独立的医学研究孤岛来推动进步和创新。然而，这种方法并不能充分应对现代医疗保健环境中的复杂性和机遇。我们认为，创建一个以目标为导向、不断学习和改进的医疗体系将最终引领医疗保健的下一次变革。我们分享约翰·霍普金斯医学中心建立质量与安全方面的学习和改进医疗体系的经验。该体系围绕明确且引人注目的以患者为中心的目标构建，并利用一个分形框架，该框架提供横向的同行学习链接和纵向的问责链接。它打破了传统的研究和临床孤岛，将基础研究与应用研究与医疗体系运营相结合。结果，该体系使包括临床医生、患者、研究人员和管理人员在内的各种利益相关者的目标和优势朝着一个共同目标保持一致。
