Abdelmalak Jonathan, Lubel John S, Sinclair Marie, Majeed Ammar, Kemp William, Roberts Stuart K
Department of Gastroenterology, Alfred Hospital, Melbourne, Victoria, Australia.
School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Hepatol Commun. 2024 Dec 11;9(1). doi: 10.1097/HC9.0000000000000595. eCollection 2025 Jan 1.
There is significant variation in HCC management across different centers with poor adherence to evidence-based clinical practice guidelines as assessed in prior studies. In Australia, quality indicators (QIs) have recently been proposed by a multidisciplinary group of experts to help provide a framework to assess and monitor the quality of HCC care. In this review, we discuss the many areas where real-world practice deviates from evidence-based medicine, the role that QI sets play in addressing this gap, and the similarities and differences between Australian QIs and other leading treatment guidelines and QI sets from around the world. We focus on the utility of QI sets to identify opportunities for targeted improvement in the real-world clinical environment. We conclude with a discussion about the formation of a national clinical quality registry as a long-term measure to facilitate continual improvements in patient care within and across sites in order to optimize patient outcomes.
正如先前研究所评估的那样,不同中心在肝癌管理方面存在显著差异,对循证临床实践指南的遵循情况较差。在澳大利亚,一个多学科专家小组最近提出了质量指标(QIs),以帮助提供一个评估和监测肝癌护理质量的框架。在本综述中,我们讨论了实际临床实践与循证医学背离的诸多领域、质量指标集在弥合这一差距中所起的作用,以及澳大利亚质量指标与其他主要治疗指南及世界各地质量指标集之间的异同。我们重点关注质量指标集在现实临床环境中识别有针对性改进机会的效用。最后,我们讨论了建立一个国家临床质量登记处的问题,作为一项长期措施,以促进各医疗机构内部及之间持续改善患者护理,从而优化患者治疗效果。