Pham Ramya, Constantinou Niki, Plecha Donna
Case Western Reserve University Hospitals, Department of Radiology, Cleveland, OH.
J Breast Imaging. 2019 Mar 13;1(1):51-55. doi: 10.1093/jbi/wby010.
Healthcare systems are constantly expanding and gaining new territories. This growth is met with challenges in the organization and delivery of quality health care services to a large geographical area. The need for provider and staff coverage at the new sites often outpaces the rate at which additional providers and staff are hired. The need for new technology, equipment, and administrative support to oversee the new sites may also lag. The overall result could compromise patient experience at these outlying locations. The breast imaging division at University Hospitals Cleveland Medical Center (UHCMC) instituted many changes to support UHCMC's continual growth while focusing on consistent quality of care and optimal patient experience. Changes included adoption of the hub-and-spoke organization-design model and incorporation of the integrated practice unit (IPU) concept. In the hub-and-spoke organization-design model, full services are offered at a central hub, with additional limited services provided at the peripheral spoke sites. The IPU is a dedicated team of clinical and nonclinical personnel providing the full care cycle centered on a specific medical condition such as breast health. The breast imaging hubs and spokes are incorporated into the breast health IPUs to provide uniform quality care across a large health system. The purpose of this article is to describe how the breast imaging division, functioning as members of the breast care IPU, utilized the hub-and-spoke concept to provide quality breast imaging services throughout the expanding health system.
医疗保健系统在不断扩张并开拓新领域。这种增长在向广大地理区域组织和提供高质量医疗服务方面面临挑战。新地点对医疗服务提供者和工作人员的需求往往超过招聘额外医疗服务提供者和工作人员的速度。对新技术、设备以及监督新地点的行政支持的需求也可能滞后。总体结果可能会损害这些偏远地区的患者体验。克利夫兰大学医院医疗中心（UHCMC）的乳腺影像科进行了多项变革，以支持UHCMC的持续发展，同时注重持续一致的医疗质量和优化患者体验。变革包括采用中心辐射型组织设计模式以及纳入综合实践单元（IPU）概念。在中心辐射型组织设计模式中，在中心枢纽提供全面服务，在外围分支地点提供额外的有限服务。IPU是由临床和非临床人员组成的专门团队，围绕特定医疗状况（如乳腺健康）提供完整的护理周期。乳腺影像中心和分支被纳入乳腺健康IPU，以便在大型医疗系统中提供统一的高质量护理。本文的目的是描述乳腺影像科作为乳腺护理IPU的成员，如何利用中心辐射型概念在不断扩张的医疗系统中提供高质量的乳腺影像服务。
