Mayo Clinic Health System in Eau Claire, Eau Claire, Wisconsin, USA
Mayo Clinic, Phoenix, Arizona, USA.
BMJ Open Qual. 2023 May;12(2). doi: 10.1136/bmjoq-2022-002230.
Mortality reviews are intended to produce transparent, non-punitive personal and organisational learning that leads to systematic improvement in care. Mayo Clinic has a well-established care review process that has accomplished that objective within our system. The establishment of a new hospital, a joint venture between Mayo Clinic and Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi, provided a unique opportunity to share this care review process internationally.During a baseline measurement period, only 78.3% of mortality reviews at SSMC were completed within 45 days, 16.7 percentage points below the target of 95%. A collaboration between SSMC and Mayo Clinic aimed to accelerate the design and implementation of a care review process system. Collaboration was constrained by travel restrictions imposed by COVID-19, language barriers, legal privacy concerns, and differing electronic health records.Mayo Clinic facilitated a 12-week virtual engagement with SSMC using weekly video meetings, education and training regarding Mayo Clinic's care review process.The engagement led to implementation of weekly mortality review huddles, restructuring of the mortality review committee to be multidisciplinary, use of a standardised taxonomy to characterise opportunities to improve care and creation of an education/communication plan regarding identified improvement opportunities using change management strategies.After the care review process for mortality reviews was instituted, SSMC achieved and sustained a target of 100% of mortality reviews completed within 45 days. The new process resulted in improved mortality review indicators and provided quality feedback to staff with engagement in performance improvement efforts.A virtual collaboration led to successful implementation of a care review process and substantial gains in the effectiveness of the quality programme at SSMC. This could serve as a model to assist other organisations, even if in-person engagement is hindered.
死亡率复核的目的是产生透明、非惩罚性的个人和组织学习，从而促使医疗照护系统得到系统性的改进。梅奥诊所拥有成熟的照护复核流程，在我们的体系内实现了这一目标。梅奥诊所与阿布扎比谢赫·沙克布特医学城（Shiekh Shakhbout Medical City，SSMC）合作建立了一家新医院，这为国际间分享这一照护复核流程提供了独特的机会。在基线测量期间，SSMC 仅有 78.3%的死亡率复核在 45 天内完成，比 95%的目标低 16.7 个百分点。SSMC 与梅奥诊所的合作旨在加速设计和实施照护复核流程系统。由于受到新冠疫情旅行限制、语言障碍、法律隐私问题以及电子健康记录不同的制约，合作受到了限制。梅奥诊所通过每周的视频会议、有关梅奥诊所照护复核流程的教育和培训，为 SSMC 提供了为期 12 周的虚拟参与机会。这次参与促使 SSMC 实施了每周死亡率复核碰头会、将死亡率复核委员会改组为多学科、使用标准化分类法来确定改善照护的机会，以及创建关于所确定改进机会的教育/沟通计划，使用了变革管理策略。在实施死亡率复核的照护复核流程后，SSMC 实现并维持了在 45 天内完成 100%死亡率复核的目标。新流程提高了死亡率复核指标，并通过参与绩效改进工作为员工提供了质量反馈。虚拟合作促成了照护复核流程的成功实施，并使 SSMC 的质量计划在效率上取得了显著提高。即使面对面的互动受到阻碍，这种模式也可以为其他组织提供帮助。
