Awdishu Linda, Moore Teri, Morrison Michelle, Turner Christy, Trzebinska Danuta
School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA 92093, USA.
Nephrology Department, School of Medicine, University of California, San Diego, CA 92093, USA.
Pharmacy (Basel). 2019 Jul 3;7(3):83. doi: 10.3390/pharmacy7030083.
Interprofessional care for chronic kidney disease facilitates the delivery of high quality, comprehensive care to a complex, at-risk population. Interprofessional care is resource intensive and requires a value proposition. Joint Commission certification is a voluntary process that improves patient outcomes, provides external validity to hospital administration and enhances visibility to patients and referring providers. This is a single-center, retrospective study describing quality assurance and performance improvement in chronic kidney disease, Joint Commission certification and quality outcomes. A total of 440 patients were included in the analysis. Thirteen quality indicators consisting of clinical and process of care indicators were developed and measured for a period of two years from 2009-2017. Significant improvements or at least persistently high performance were noted for key quality indicators such as blood pressure control (85%), estimation of cardiovascular risk (100%), measurement of hemoglobin A1c (98%), vaccination (93%), referrals for vascular access and transplantation (100%), placement of permanent dialysis access (61%), discussion of advanced directives (94%), online patient education (71%) and completion of office visit documentation (100%). High patient satisfaction scores (94-96%) are consistent with excellent quality of care provided.
慢性肾脏病的跨专业护理有助于为复杂的高危人群提供高质量、全面的护理。跨专业护理资源密集，需要有价值主张。联合委员会认证是一个自愿过程，可改善患者预后，为医院管理提供外部有效性，并提高对患者和转诊提供者的可见性。这是一项单中心回顾性研究，描述了慢性肾脏病的质量保证和绩效改进、联合委员会认证及质量结果。分析共纳入440例患者。制定了由临床和护理过程指标组成的13项质量指标，并在2009年至2017年的两年时间内进行测量。关键质量指标取得了显著改善或至少持续保持高性能，如血压控制（85%）、心血管风险评估（100%）、糖化血红蛋白测量（98%）、疫苗接种（93%）、血管通路和移植转诊（100%）、永久性透析通路置入（61%）、生前预嘱讨论（94%）、在线患者教育（71%）以及门诊记录完成情况（100%）。高患者满意度评分（94 - 96%）与所提供的优质护理一致。
