Morduchowicz Sasha, Lee Jonathan S, Choi Lei, Kivlahan Coleen, Null Dan, Smith Susan, Feldman Mitchell D
Faculty Practice Operations & Ambulatory Services, University of California, San Francisco, San Francisco, CA, USA.
Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
J Gen Intern Med. 2020 Dec;35(12):3650-3655. doi: 10.1007/s11606-020-06246-7. Epub 2020 Sep 28.
This Perspective presents a case study of multidimensional clinical transformation in an academic general internal medicine practice. In the face of increasing internal and external pressures, health systems and individual medical practices have pursued multiple strategies to improve quality, patient experience, and efficiency, while reducing staff and provider stress and burnout. We describe a Lean-informed approach that emphasizes the importance of organizational alignment in goals, evidence-based problem solving, and leadership behaviors to support a culture of continuous improvement. Our aim in this Perspective is to provide a real-world example of a feasible process for the planning, preparation, and execution of effective transformation, and to present lessons that may be useful to other academic health center practices seeking to develop innovative models to achieve the quadruple aim.
本视角呈现了一个学术性普通内科实践中多维临床转型的案例研究。面对日益增加的内部和外部压力，医疗系统和个体医疗实践采取了多种策略来提高质量、患者体验和效率，同时减轻员工和医疗服务提供者的压力与倦怠。我们描述了一种基于精益理念的方法，该方法强调目标的组织一致性、循证问题解决以及支持持续改进文化的领导行为的重要性。我们在本视角中的目的是提供一个关于有效转型的规划、准备和执行的可行流程的真实案例，并呈现一些经验教训，这些经验教训可能对其他寻求开发创新模式以实现四重目标的学术健康中心实践有所帮助。
