Postdoctoral Fellow, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: https://twitter.com/MonicaMirandaSc.
Quality Improvement Manager, Department of Radiology, Stanford University School of Medicine, Stanford, California.
J Am Coll Radiol. 2023 Feb;20(2):173-182. doi: 10.1016/j.jacr.2022.08.014. Epub 2022 Oct 20.
The purpose of this project was to describe the results of a multi-institutional quality improvement (QI) program conducted in a virtual format.
Developed at Stanford in 2016, the Realizing Improvement Through Team Empowerment program uses a team-based, project-based improvement approach to QI. The program was planned to be replicated at two other institutions through respective on-site programs but was converted to a multi-institutional virtual format in 2020 in response to the COVID-19 pandemic. The virtual program began in July 2020 and ended in December 2020. The two institutions participated jointly in the cohort, with 10 2-hour training sessions every 2 weeks for a total of 18 weeks. Project progress was monitored using a predetermined project progress scale by the program manager, who provided more direct project support as needed.
The cohort consisted of six teams (37 participants) from two institutions. Each team completed a QI project in subjects including MRI, ultrasound, CT, diagnostic radiography, and ACR certification. All projects reached levels of between 3.0 (initial test cycles begun with evidence of modest improvement) and 4.0 (performance data meeting goal and statistical process control criteria for improvement) and met graduation criteria for program completion.
We found the structured problem-solving method, along with timely focused QI education materials via a virtual platform, to be effective in simultaneously facilitating improvement projects from multiple institutions. The combination of two institutions fostered encouragement and shared learning across institutions.
本项目旨在描述以虚拟形式进行的多机构质量改进(QI)计划的结果。
斯坦福大学于 2016 年开发的“通过团队授权实现改进”(Realizing Improvement Through Team Empowerment)计划采用了基于团队、基于项目的改进方法来进行 QI。该计划原本计划在另外两所机构通过各自的现场计划进行复制,但在 2020 年因 COVID-19 大流行而改为多机构虚拟模式。虚拟计划于 2020 年 7 月开始,2020 年 12 月结束。两所机构联合参加了该队列,每两周进行一次共 10 次 2 小时的培训,共 18 周。项目进度由项目经理使用预定的项目进度量表进行监测,项目经理根据需要提供更直接的项目支持。
该队列由来自两个机构的六个团队(37 名参与者)组成。每个团队都在 MRI、超声、CT、诊断放射学和 ACR 认证等主题中完成了一个 QI 项目。所有项目都达到了 3.0 级(初始测试循环开始时显示出适度的改进)和 4.0 级(绩效数据达到目标,并且符合改进的统计过程控制标准),并达到了项目完成的毕业标准。
我们发现,结构化的问题解决方法,以及通过虚拟平台及时提供有针对性的 QI 教育材料,对于同时促进多个机构的改进项目非常有效。两所机构的合作促进了机构之间的鼓励和共同学习。