Institute of Neurosciences, Apollo Hospitals OMR and Vanagaram, Chennai, Tamil Nadu, India.
Acta Neurochir Suppl. 2023;130:207-216. doi: 10.1007/978-3-030-12887-6_25.
Measure something, and it gets better-this is what is called as the Hawthorne effect (also known as the observer effect). The Hawthorne factory experiments in 1920s were remarkable industrial data collection and analysis exercises that lead to Edwards Deming's quality revolution. The Harvard Medical Practice Study (1991), Leape's "Error in Medicine" (1994), and the Bristol pediatric cardiac report (2001) are among many documents that have revealed the huge gap between best practices and actual medical practice. Alarmed by the poor standards of quality at the most respected institutions, the medical fraternity therefore began visiting facilities in different fields and observing their quality assessment processes. The next leap for neurosurgery is to realize that it is unacceptable to treat patients with no regard for the standard of clinical outcomes. The traditional neurosurgery residency training has long ignored the most important issues of self-assessment, reappraisal, relearning, and measurement of skill and surgical outcomes. However, the experience taken from disparate fields, especially cardiac surgery, may encourage research and progress in measurement and improvement of quality in neurosurgery. Like cardiac surgeons, neurosurgeons must examine and analyze the results of their interventions. The concept of quality measurement is the most important single advance we can make in neurosurgery practice. Meticulous and precise measurement of outcomes will allow future progress of our specialty.
衡量某些东西，它就会变得更好——这就是所谓的霍桑效应（也称为观察者效应）。20 世纪 20 年代的霍桑工厂实验是非常出色的工业数据收集和分析实践，为爱德华兹·戴明（Edwards Deming）的质量革命奠定了基础。哈佛医疗实践研究（1991 年）、利普的《医学中的错误》（1994 年）和布里斯托尔儿科心脏报告（2001 年）等众多文件揭示了最佳实践与实际医疗实践之间的巨大差距。由于最受尊敬的医疗机构的质量标准令人担忧，医学界因此开始访问不同领域的设施并观察其质量评估过程。神经外科学的下一个飞跃是认识到不考虑临床结果标准来治疗患者是不可接受的。传统的神经外科住院医师培训长期以来忽视了自我评估、重新评估、重新学习以及技能和手术结果衡量等最重要的问题。然而，从不同领域获得的经验，特别是心脏外科学，可能会鼓励神经外科学在测量和提高质量方面的研究和进展。像心脏外科医生一样，神经外科医生必须检查和分析他们干预的结果。质量测量的概念是我们在神经外科学实践中可以取得的最重要的单一进步。对结果进行细致和精确的衡量将允许我们专业的未来取得进步。
