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质量改进学习协作组织改善了新生儿后续预约的及时性。

Quality Improvement Learning Collaborative Improves Timely Newborn Follow-Up Appointments.

作者信息

Scott Emily, Downs Stephen, Pottenger Amy, Saysana Michele

出版信息

Jt Comm J Qual Patient Saf. 2019 Dec;45(12):808-813. doi: 10.1016/j.jcjq.2019.08.005. Epub 2019 Oct 10.

Abstract

BACKGROUND

American Academy of Pediatrics guidelines indicate that newborns should follow up with their primary care providers within three days of discharge from the newborn nursery. Many barriers exist to achieving timely follow-up, with potential implications on a newborn's health. The goal of this project was to improve rates of timely newborn follow-up through a nine-month quality improvement learning collaborative (QILC). Timely newborn follow-up was defined as an appointment scheduled within three days of newborn discharge.

METHODS

Both inpatient hospitalist and outpatient pediatric practices were eligible to participate. Inpatient and outpatient practices aimed to have 75% of newborns scheduled appropriately by six months into the project. In addition, outpatient practices aimed to have 60% of newborns seen appropriately by their provider. All practices aimed to have their progress sustained at conclusion of the QILC. Practices submitted data at baseline and nine subsequent phases. Monthly webinars featured a quality improvement didactic, data review, and discussion of practices' changes, successes, and challenges.

RESULTS

Eleven practices and 24 physicians participated in the QILC. Aggregate data from the practices showed continual improvement in all measured newborn scheduling metrics throughout the nine-month learning collaborative, with sustainment of progress over the last three months of the QILC.

CONCLUSION

A QILC is successful for increasing timely newborn follow-up for both the newborn hospitalist and outpatient pediatrician. Pediatric providers can learn from others' strategies and successes to incorporate meaningful changes in their practice.

摘要

背景

美国儿科学会指南指出,新生儿应在从新生儿重症监护室出院后的三天内接受初级保健提供者的随访。实现及时随访存在许多障碍,这可能会对新生儿的健康产生影响。该项目的目标是通过为期九个月的质量改进学习协作(QILC)提高新生儿及时随访率。及时的新生儿随访定义为在新生儿出院后三天内安排的预约。

方法

住院医师和门诊儿科诊所均有资格参与。住院医师和门诊诊所的目标是在项目进行到六个月时,75%的新生儿得到适当安排。此外,门诊诊所的目标是让60%的新生儿得到其提供者的适当诊治。所有诊所的目标是在QILC结束时保持其进展。诊所在基线和随后的九个阶段提交数据。每月的网络研讨会包括质量改进教学、数据审查以及对诊所变化、成功经验和挑战的讨论。

结果

11家诊所和24名医生参与了QILC。这些诊所的汇总数据显示,在为期九个月的学习协作中,所有测量的新生儿预约指标都持续改善,并且在QILC的最后三个月保持了进展。

结论

QILC在提高新生儿住院医师和门诊儿科医生的新生儿及时随访率方面取得了成功。儿科提供者可以借鉴他人的策略和成功经验,在其实践中纳入有意义的改变。

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