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为质量编码?标准化癌症患者诊疗路径中的问责工作。

Coding for quality? Accountability work in standardised cancer patient pathways (CPPs).

作者信息

Håland Erna, Melby Line

机构信息

Norwegian University of Science and Technology (NTNU), Norway.

Sintef, Norway.

出版信息

Health (London). 2023 Jan;27(1):129-146. doi: 10.1177/13634593211013882. Epub 2021 Apr 30.

DOI:10.1177/13634593211013882
PMID:33926302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9743077/
Abstract

A vital part of standardised care pathways is the possibility to measure performance through different indicators - for example, codes. In this article, based on interviews with health personnel in a project evaluating the introduction of standardised cancer patient pathways (CPPs) in Norway, we explore All the types of work are dimensions of what we define as - work health personnel do to make the codes signifiers of quality of care in the CPP.Codes and coding practices raise questions of what quality of care represents and how it could and should be measured. Informants in our study advocate for coding as important work more than for 'the system'. This shows how for quality becomes a crucial part of professional work, expanding what it means to perform high quality care.

摘要

标准化护理路径的一个重要部分是通过不同指标(例如编码)来衡量绩效的可能性。在本文中,基于对挪威一个评估标准化癌症患者路径(CPPs)引入情况的项目中的卫生人员的访谈,我们探讨了所有类型的工作都是我们所定义的——卫生人员为使编码成为CPP中护理质量的标识符而做的工作的维度。编码和编码实践引发了关于护理质量代表什么以及如何能够且应该进行衡量的问题。我们研究中的受访者主张将编码视为重要工作,而不仅仅是为了“系统”。这表明了对质量的追求如何成为专业工作的关键部分,扩展了高质量护理的含义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d257/9743077/deb995f4889c/10.1177_13634593211013882-img2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d257/9743077/deb995f4889c/10.1177_13634593211013882-img2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d257/9743077/deb995f4889c/10.1177_13634593211013882-img2.jpg

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本文引用的文献

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Data work in healthcare: An Introduction.医疗保健中的数据工作:简介
Health Informatics J. 2019 Sep;25(3):465-474. doi: 10.1177/1460458219864730.
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Pathways to professionalism? Quality improvement, care pathways, and the interplay of standardisation and clinical autonomy.通往职业化之路?质量改进、护理路径以及标准化与临床自主性的相互作用。
Sociol Health Illn. 2017 Nov;39(8):1314-1329. doi: 10.1111/1467-9566.12585. Epub 2017 Jun 21.
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Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care.
实施老年患者护理路径:初级保健中的比较性定性过程评估
BMC Health Serv Res. 2015 Mar 4;15:86. doi: 10.1186/s12913-015-0751-1.
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Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services.作为初级保健和二级保健之间边界对象的护理路径:来自挪威家庭护理服务的经验。
Health (London). 2015 Nov;19(6):635-51. doi: 10.1177/1363459314567789. Epub 2015 Jan 26.
5
Lost in translation? 'Evidence' and the articulation of institutional logics in integrated care pathways: from positive to negative boundary object?迷失在翻译中?“证据”与综合护理路径中制度逻辑的阐述:从积极的边界对象到消极的边界对象?
Sociol Health Illn. 2014 Jul;36(6):807-22. doi: 10.1111/1467-9566.12111. Epub 2014 Mar 17.
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Understanding context for quality improvement: artefacts, affordances and socio-material infrastructure.理解质量改进的背景:人工制品、可供性和社会物质基础设施。
Health (London). 2013 Sep;17(5):460-77. doi: 10.1177/1363459312464072. Epub 2012 Nov 1.
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Introducing the electronic patient record (EPR) in a hospital setting: boundary work and shifting constructions of professional identities.在医院环境中引入电子病历 (EPR):边界工作和专业身份的转变。
Sociol Health Illn. 2012 Jun;34(5):761-75. doi: 10.1111/j.1467-9566.2011.01413.x. Epub 2011 Oct 25.
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Systematic review of the effectiveness of integrated care pathways: what works, for whom, in which circumstances?系统评价综合护理路径的有效性:哪些有效,针对哪些人群,在哪些情况下?
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Pragmatic evidence and textual arrangements: a case study of French clinical cancer guidelines.实用证据与文本编排:以法国癌症临床指南为例
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From boundary concept to boundary object: the practice and politics of care pathway development.从边界概念到边界对象:护理路径开发的实践与政治。
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