From the Department of Surgery, Carolinas Medical Center, Charlotte, NC (Lyman, Matthews); and the Division of HPB Surgery, Carolinas Medical Center, Charlotte, NC (Passeri, Murphy, Cochran, Iannitti, Martinie, Baker, Vrochides).
Can J Surg. 2020 Mar 13;63(2):E120-E122. doi: 10.1503/cjs.000519.
A similar theme unites proposed solutions for stagnant improvement in outcomes and rising health care costs: eliminate unnecessary variation in the care of surgical patients. While large quality-improvement projects like the Americal College of Surgeons National Surgical Quality Improvement Program have historically led to improved patient outcomes at the hospital level, the next step in surgical quality improvement is to eliminate unnecessary variation at the level of the individual surgeon. Critical examination of individualized clinical, financial and patient-reported outcomes — outcome situational awareness — along with peer group comparison will help surgeons to identify variation in patient care. We are piloting an interactive software platform at our institution to provide information on individualized clinical, financial and patient-reported outcomes in real time through automatic data population of a central REDCap database. These individualized data along with peer group comparison allow surgeons to objectively determine areas of potential improvement.
一个类似的主题将提出的解决方案统一起来，以解决手术患者护理方面的进展缓慢和医疗保健成本上升的问题：消除手术患者护理中不必要的差异。虽然像美国外科医师学院国家外科质量改进计划这样的大型质量改进项目历史上已经提高了医院层面的患者预后，但手术质量改进的下一步是消除个体外科医生层面的不必要差异。对个体化临床、财务和患者报告结果的关键检查——结果态势感知——以及同行比较将帮助外科医生识别患者护理中的差异。我们正在我们的机构中试点一个交互式软件平台，通过自动填充中央 REDCap 数据库来实时提供个体化临床、财务和患者报告结果的信息。这些个体化数据以及同行比较使外科医生能够客观地确定潜在的改进领域。
