家庭医疗中的质量改进。子宫颈抹片检查项目。
Quality improvement in family practice. Program for Pap smears.
作者信息
Norton P G, Shaw P A, Murray M A
机构信息
Department of Family and Community Medicine, University of Toronto.
出版信息
Can Fam Physician. 1997 Mar;43:503-8.
PROBLEM BEING ADDRESSED
With the increasing emphasis on quality improvement, we need programs for improving office practice.
OBJECTIVE OF PROGRAM
To demonstrate a simple and inexpensive program that resulted in improvement in the quality of Papanicolaou smears in a family practice teaching clinic. The performance measure was the proportion of smears containing endocervical components.
MAIN COMPONENTS OF PROGRAM
The program involved annual feedback on the performance of the physicians in the clinic. Feedback was given to physicians at a regular group meeting; brief discussion of the findings also occurred at that time. There were no other interventions.
CONCLUSIONS
A program involving straightforward feedback and discussion for less than 1 hour contributed to a 7% improvement in the proportion of Pap smears with endocervical components. This "low tech" approach should be tested in other settings and with other procedures and treatments.
所解决的问题
随着对质量改进的日益重视，我们需要改善门诊医疗实践的方案。
方案目标
展示一个简单且成本低廉的方案，该方案能使一家家庭医疗教学诊所的巴氏涂片质量得到改善。绩效衡量指标是含有宫颈管成分涂片的比例。
方案的主要组成部分
该方案包括每年对诊所医生的表现进行反馈。在定期的小组会议上向医生提供反馈；同时也会对结果进行简短讨论。没有其他干预措施。
结论
一个涉及直接反馈和不到1小时讨论的方案使含有宫颈管成分的巴氏涂片比例提高了7%。这种“低技术”方法应在其他环境以及其他程序和治疗中进行测试。
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