Affeldt J E
West J Med. 1980 Feb;132(2):166-70.
The Joint Commission on Accreditation of Hospitals (JCAH) has continuously emphasized improvement in the quality of care provided in hospitals as the central purpose of the accreditation process. In striving to assure such improvement, the JCAH has stressed the need for, and the responsibility of, the medical and other professional staffs to provide continuing review and evaluation of patient care. In recent years, quality assessment activities have evolved, proliferated and matured to the extent that they require a purposeful integration if they are to effect sustained improvement in patient care and clinical performance. To assist hospitals in the coordination or integration of quality assessment activities, the Board of Commissioners of the JCAH has approved an important new quality assurance standard. Significant requirements of the new standard are a comprehensive quality assurance program, a written plan, a problem-focused approach to the review and evaluation of patient care and clinical performance, an annual reassessment of the program, and an improvement in patient care or clinical performance. The new standard reflects the JCAH belief that an integrated, problem-focused approach to quality assurance will significantly improve the quality of care provided throughout a hospital. Such an approach recognizes the interdependence of hospital departments and services in the provision of patient care, and, therefore, requires a purposeful integration or coordination of quality assessment data and activities. Consequently, quality assessment data may be utilized effectively and efficiently, and many potentially useless or duplicative quality assessment activities can be eliminated. The new standard affords hospitals considerable flexibility in the manner in which they implement and administer the program and encourages innovation.
医院评审联合委员会(JCAH)一直强调,提升医院提供的护理质量是评审过程的核心目标。为努力确保实现这一提升,JCAH强调了医疗及其他专业人员进行持续审查和评估患者护理的必要性及责任。近年来,质量评估活动不断发展、增多并成熟,以至于若要在患者护理和临床绩效方面实现持续改进,就需要进行有目的的整合。为协助医院协调或整合质量评估活动,JCAH委员会已批准一项重要的新质量保证标准。新标准的重要要求包括全面的质量保证计划、书面计划、以问题为导向的患者护理和临床绩效审查与评估方法、对该计划的年度重新评估,以及患者护理或临床绩效的改进。新标准体现了JCAH的信念,即采用综合的、以问题为导向的质量保证方法将显著提高整个医院提供的护理质量。这种方法认识到医院各科室和服务在提供患者护理方面的相互依存关系,因此需要有目的地整合或协调质量评估数据及活动。这样一来,质量评估数据就能得到有效利用,许多潜在无用或重复的质量评估活动也可被消除。新标准在医院实施和管理该计划的方式上给予了相当大的灵活性,并鼓励创新。