Ruiz Colón Gabriela D, Wu Adela, Ratliff John K, Prolo Laura M
Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, 94304, USA.
Division of Pediatric Neurosurgery, Lucile Packard Children's Hospital, Palo Alto, CA, 94304, USA.
Childs Nerv Syst. 2023 May;39(5):1147-1158. doi: 10.1007/s00381-022-05821-z. Epub 2023 Jan 25.
In 2001, the National Academy of Medicine, formerly known as the Institute of Medicine (IOM), published their seminal work, Crossing the Quality Chasm: A New Health System for the 21st Century. In this work, the authors called for improved safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity in the United States' healthcare system. Two decades after the publication of this work, healthcare costs continue to rise, but outcomes lag other nations. The objective of this narrative review is to describe research efforts in pediatric neurosurgery with respect to the six quality aims proposed by the IOM, and highlight additional research opportunities.
PubMed, Google Scholar, and EBSCOhost were queried to identify studies in pediatric neurosurgery that have addressed the aims proposed by the IOM. Studies were summarized and synthesized to develop a set of research opportunities to advance quality of care.
Twenty-three studies were reviewed which focused on the six quality aims proposed by the IOM. Out of these studies, five research opportunities emerged: (1) To examine performance of tools of care, (2) To understand processes surrounding care delivery, (3) To conduct cost-effectiveness analyses for a broader range of neurosurgical conditions, (4) To identify barriers driving healthcare disparities, and (5) To understand patients' and caregivers' experiences receiving care, and subsequently develop tools and programs to address their needs and preferences.
There is a growing body of literature examining quality in pediatric neurosurgical care across all aims proposed by the IOM. However, there remains important gaps in the literature that, if addressed, will advance the quality of pediatric neurosurgical care delivery.
2001年，美国国家医学院（前身为医学研究所，即IOM）发表了其开创性著作《跨越质量鸿沟：21世纪的新医疗体系》。在这部著作中，作者呼吁改善美国医疗体系的安全性、有效性、以患者为中心、及时性、效率和公平性。这部著作发表二十年后，医疗成本持续上升，但医疗结果却落后于其他国家。本叙述性综述的目的是描述小儿神经外科在IOM提出的六个质量目标方面的研究工作，并突出其他研究机会。
检索了PubMed、谷歌学术和EBSCOhost，以确定小儿神经外科领域中涉及IOM提出目标的研究。对研究进行了总结和综合，以开发一系列提高医疗质量的研究机会。
共审查了23项专注于IOM提出的六个质量目标的研究。在这些研究中，出现了五个研究机会：（1）检查护理工具的性能；（2）了解护理提供过程；（3）对更广泛的神经外科疾病进行成本效益分析；（4）确定导致医疗差距的障碍；（5）了解患者和护理人员接受护理的体验，随后开发工具和项目以满足他们的需求和偏好。
越来越多的文献探讨了小儿神经外科护理在IOM提出的所有目标方面的质量。然而，文献中仍存在重要差距，如果这些差距得到解决，将提高小儿神经外科护理的质量。
