Department of Performance Excellence, Duke University Health System, One Renaissance Centre, Raleigh, NC Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC Department of Public Health Leadership, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC.
Am J Med Qual. 2021;36(5):328-336. doi: 10.1097/01.JMQ.0000735456.03039.2e.
Health care is at a critical moment. High rates of medical errors and decreasing quality of health care make it crucial that organizations focus on quality improvement (QI). For this work to be successful, it is essential to engage physicians, as they are key decision-makers, leaders, and influencers of care. Despite this fact, few organizations have successfully sustained physician engagement in QI. A scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to understand barriers to and strategies for engaging physicians in QI. The most commonly cited strategies were: (1) having engaged and supportive senior leadership and (2) having data support for QI work. Additional strategies included: dedicated time, resources, and education for QI work; financial incentives; clarifying organizational goals; and developing pathways for promotion. A framework was then created to operationalize physician engagement in QI in the organization.
医疗保健正处于关键时刻。医疗差错率居高不下,医疗质量不断下降,这使得组织必须专注于质量改进(QI)。要想使这项工作取得成功,就必须让医生参与进来,因为他们是关键的决策者、领导者和医疗保健的影响者。尽管事实如此,但很少有组织能够成功地让医生持续参与质量改进。本研究采用系统评价和荟萃分析的首选报告项目进行了范围审查,以了解在质量改进中阻碍和激励医生参与的因素。最常被引用的策略是:(1)拥有积极支持的高层领导;(2)为质量改进工作提供数据支持。其他策略包括:为质量改进工作分配专门的时间、资源和教育;提供财务激励;明确组织目标;并为晋升制定途径。然后创建了一个框架,以便在组织中实施医生参与质量改进。