Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Maternal Metrics, Inc, North Hollywood, CA, USA.
Matern Child Health J. 2023 Sep;27(9):1460-1471. doi: 10.1007/s10995-023-03720-6. Epub 2023 Jun 22.
Patient-reported outcomes and experiences (PRO) data are an integral component of health care quality measurement and PROs are now being collected by many healthcare systems. However, hospital organizational capacity-building for the collection and sharing of PROs is a complex process. We sought to identify the factors that facilitated capacity-building for PRO data collection in a nascent quality improvement learning collaborative of 16 hospitals that has the goal of improving the childbirth experience.
We used standard qualitative case study methodologies based on a conceptual framework that hypothesizes that adequate organizational incentives and capacities allow successful achievement of project milestones in a collaborative setting. The 4 project milestones considered in this study were: (1) Agreements; (2) System Design; (3) System Development and Operations; and (4) Implementation. To evaluate the success of reaching each milestone, critical incidents were logged and tracked to determine the capacities and incentives needed to resolve them.
The pace of the implementation of PRO data collection through the 4 milestones was uneven across hospitals and largely dependent on limited hospital capacities in the following 8 dimensions: (1) Incentives; (2) Leadership; (3) Policies; (4) Operating systems; (5) Information technology; (6) Legal aspects; (7) Cross-hospital collaboration; and (8) Patient engagement. From this case study, a trajectory for capacity-building in each dimension is discussed.
The implementation of PRO data collection in a quality improvement learning collaborative was dependent on multiple organizational capacities for the achievement of project milestones.
患者报告的结果和体验（PRO）数据是医疗保健质量衡量的一个组成部分，现在许多医疗保健系统都在收集 PRO 数据。然而，医院在收集和共享 PRO 方面的组织能力建设是一个复杂的过程。我们旨在确定在一个由 16 家医院组成的新兴质量改进学习合作组织中促进 PRO 数据收集的能力建设的因素，该合作组织的目标是改善分娩体验。
我们使用了基于概念框架的标准定性案例研究方法，该框架假设充分的组织激励和能力允许在协作环境中成功实现项目里程碑。本研究考虑了 4 个项目里程碑：（1）协议；（2）系统设计；（3）系统开发和运营；（4）实施。为了评估达到每个里程碑的成功程度，记录并跟踪了关键事件，以确定解决这些事件所需的能力和激励措施。
通过 4 个里程碑实施 PRO 数据收集的速度在医院之间不均衡，主要取决于以下 8 个方面的有限医院能力：（1）激励措施；（2）领导力；（3）政策；（4）操作系统；（5）信息技术；（6）法律方面；（7）跨医院合作；（8）患者参与。从这个案例研究中，讨论了每个维度的能力建设轨迹。
在质量改进学习合作组织中实施 PRO 数据收集依赖于实现项目里程碑的多个组织能力。
