AT Medics Ltd, London, London, UK.
School of Population Health and Environmental Sciences, King's College London, London, UK.
BMJ Open Qual. 2021 Feb;10(1). doi: 10.1136/bmjoq-2020-001087.
A quality improvement (QI) scheme was launched in 2017, covering a large group of 25 general practices working with a deprived registered population. The aim was to improve the measurable quality of care in a population where type 2 diabetes (T2D) care had previously proved challenging. A complex set of QI interventions were co-designed by a team of primary care clinicians and educationalists and managers. These interventions included organisation-wide goal setting, using a data-driven approach, ensuring staff engagement, implementing an educational programme for pharmacists, facilitating web-based QI learning at-scale and using methods which ensured sustainability. This programme was used to optimise the management of T2D through improving the eight care processes and three treatment targets which form part of the annual national diabetes audit for patients with T2D. With the implemented improvement interventions, there was significant improvement in all care processes and all treatment targets for patients with diabetes. Achievement of all the eight care processes improved by 46.0% (p<0.001) while achievement of all three treatment targets improved by 13.5% (p<0.001). The QI programme provides an example of a data-driven large-scale multicomponent intervention delivered in primary care in ethnically diverse and socially deprived areas.
2017 年启动了一项质量改进 (QI) 计划，涵盖了 25 家普通实践，为一个贫困的注册人口提供服务。其目的是提高 2 型糖尿病 (T2D) 护理方面的可衡量护理质量，因为此前在这方面的护理存在挑战。一组初级保健临床医生、教育工作者和管理人员共同设计了一系列复杂的 QI 干预措施。这些干预措施包括在全组织范围内设定目标、采用数据驱动的方法、确保员工参与、为药剂师实施教育计划、促进大规模基于网络的 QI 学习以及使用确保可持续性的方法。该计划用于通过改善构成 T2D 年度国家糖尿病审计的八项护理流程和三项治疗目标来优化 T2D 的管理。通过实施改进干预措施，糖尿病患者的所有护理流程和所有治疗目标都有显著改善。所有八项护理流程的完成率提高了 46.0%（p<0.001），而所有三项治疗目标的完成率提高了 13.5%（p<0.001）。QI 计划为在种族多样化和社会贫困地区提供以数据为驱动的大规模多组分干预措施提供了一个范例。
