Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Center of Integrated Oncology ABCD, University Hospital of Cologne, Cologne, Germany.
J Healthc Qual Res. 2024 Jan-Feb;39(1):32-40. doi: 10.1016/j.jhqr.2023.10.007. Epub 2023 Nov 18.
Quality management in healthcare is essential for safe, effective, and patient-centered services. Quality management systems (QMS) monitor and improve healthcare quality. Integrating QMS is crucial for optimal quality of care, but previous studies show gaps in integration. This study aims to assess program adherence to a QMS in cross-sectoral psycho-oncological care and to develop strategies for better integration, ultimately improving healthcare quality.
The study used a utility analysis to assess the program adherence of a cross-sectoral psycho-oncology care program using a 5-point scale. The evaluation process involved breaking down the program into distinct areas, and used key figures and developed indicators to assess adherence. Descriptive statistics were used.
The study conducted a comprehensive assessment of program adherence in a complex care program, analysing 4460 evaluation cases based on 128 quality indicators. The results showed a score of 4.2 out of 5 points (84%), indicating a highly effective implementation of the QMS. Notably, the study observed successful implementation of top-down elements, while encountering more challenges in integrating bottom-up aspects.
The study demonstrates effective implementation of a comprehensive QMS. Successful integration was observed in areas such as care concept, care management, quality assurance, and IT-based documentation, while challenges remain in quality development and indicators. Active leadership involvement, staff training, data collection, and a learning culture are essential for successful implementation. Future research should assess the impact and cost-effectiveness of QMSs and develop tailored approaches to sustain healthcare professionals' motivation in quality improvement efforts.
医疗保健中的质量管理对于安全、有效和以患者为中心的服务至关重要。质量管理系统（QMS）可监测和改进医疗保健质量。整合 QMS 对于最佳护理质量至关重要，但先前的研究表明整合存在差距。本研究旨在评估跨部门心理肿瘤学护理计划对 QMS 的遵守情况，并制定更好的整合策略，最终提高医疗保健质量。
该研究使用效用分析，使用 5 分制评估跨部门心理肿瘤学护理计划的方案遵守情况。评估过程涉及将计划分解为不同的领域，并使用关键数据和开发的指标来评估遵守情况。使用描述性统计。
该研究对复杂护理计划中的方案遵守情况进行了全面评估，根据 128 个质量指标分析了 4460 个评估案例。结果显示，5 分制得分为 4.2 分（84%），表明 QMS 的实施非常有效。值得注意的是，该研究观察到自上而下元素的成功实施，而在整合自下而上方面则遇到了更多挑战。
该研究表明全面 QMS 的有效实施。在护理理念、护理管理、质量保证和基于 IT 的文档方面观察到成功的整合，而在质量发展和指标方面仍存在挑战。积极的领导力参与、员工培训、数据收集和学习文化对于成功实施至关重要。未来的研究应评估 QMS 的影响和成本效益，并制定针对特定情况的方法，以维持医疗保健专业人员在质量改进工作中的积极性。
