Booth F V
Department of Surgery, State University of New York, Buffalo.
Crit Care Clin. 1993 Jul;9(3):477-89.
The following six points offer a summary of principles to the manager who must develop a QA program: Institutional commitment to the QA process is essential for success. This must be embodied in the table of organization for QA and the commitment of resources to the task. The QA plan should address mechanisms for data collection, data review, and outcome reporting. Lines of responsibility should be stated clearly. The manner in which the outcomes of the QA process are implemented and communicated back to the front-line workers must be clearly stated and continually fed back to them. Clinical evaluations work best in the presence of politically neutral practice guidelines. Vociferous complainers frequently can be made part of the process, harnessing their energy to good effect. Self survey should precede an accreditation site visit by at least 6 months. The best sources of JCAHO thinking on QA methods are the many JCAHO publications, several of which focus on the critical care arena.
机构对质量保证过程的承诺是成功的关键。这必须体现在质量保证的组织架构表以及为该任务投入的资源中。质量保证计划应涵盖数据收集、数据审查和结果报告的机制。责任界限应明确规定。必须清楚说明质量保证过程的结果如何实施并反馈给一线工作人员，并持续向他们反馈。在存在政治中立的实践指南的情况下，临床评估效果最佳。经常可以让大声抱怨的人参与到这个过程中，将他们的能量发挥出好的效果。自我调查应在评审机构现场考察前至少6个月进行。联合委员会（JCAHO）关于质量保证方法的最佳思想来源是联合委员会的众多出版物，其中有几本专注于重症监护领域。
