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脊柱手术的质量与安全改进

Quality and Safety Improvement in Spine Surgery.

作者信息

Jiang Fan, Wilson Jamie R F, Badhiwala Jetan H, Santaguida Carlo, Weber Michael H, Wilson Jefferson R, Fehlings Michael G

机构信息

Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

University of Toronto, Toronto, Ontario, Canada.

出版信息

Global Spine J. 2020 Jan;10(1 Suppl):17S-28S. doi: 10.1177/2192568219839699. Epub 2020 Jan 6.

Abstract

STUDY DESIGN

Review article.

OBJECTIVES

A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery.

METHODS

A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review.

RESULTS

Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature.

CONCLUSION

Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

摘要

研究设计

综述文章。

目的

对脊柱外科质量与安全改进举措的当前进展及局限性相关文献进行叙述性综述。

方法

使用Ovid MEDLINE进行全面的文献检索,重点关注3个预先确定的概念:(1)质量与安全改进;(2)结果及不良事件报告;(3)预测模型与实践指南。检索在适当的主题词下进行,并使用相关文本词。对文章进行筛选,与本讨论相关的手稿纳入叙述性综述。

结果

质量与安全改进仍然是吸引全球脊柱领域研究人员的主要研究重点。为了生成数据和监测质量与安全改进举措的进展,已经建立了多个数据库和登记处。各种预测模型和临床实践指南的发展有助于塑造现代脊柱患者的护理模式。随着西北脊柱团队和西雅图脊柱团队发起的示范项目取得成功,预计其他质量与安全改进举措也将随之而来。然而,尽管有这些进展,但结果和不良事件的报告指标在文献中仍然存在差异。

结论

在现代医疗保健中,持续监测和不断改进脊柱治疗的质量与安全至关重要。尽管已经取得了巨大进展,但结果和不良事件报告方面的问题仍然存在,这方面肯定需要改进。

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