Maguerez G
National Quality Assurance Program, ANDEM, Paris, France.
Jt Comm J Qual Improv. 1997 Jan;23(1):33-7. doi: 10.1016/s1070-3241(16)30292-9.
In France interest in continuous quality improvement (CQI) and other quality improvement (QI) approaches is recent and experience modest, but the pace of change should quicken now that the government has required that all hospitals be accredited within the next five years. In addition, in the face of increasing competition, hospitals, public and private, may find a quality strategy to be critical in helping them survive.
In fall 1994 the National Agency for the Promotion of Medical Evaluation (ANDEM) was mandated by the Ministry of Health to set up a national demonstration project based on quality assurance and CQI methodologies. The program was designed to identify the key success factors for implementing such programs within hospitals. The program involves 28 18-month CQI projects, which deal with prevention of nosocomial infection, patient safety in anesthesia, medical records, blood transfusion safety, drug dispensing safety, and control of violence in psychiatric settings. Participating hospitals are required to analyze the variation in the involved processes and attempt to reduce variation through cross-departmental quality management programs. The general method for each team's management of the project closely follows the PDCA (Plan-Do-Check-Act) cycle. Preliminary experience suggests that the participating hospitals have benefited from following the same model and sharing of accounts of their progress. Representatives of the 28 teams met in fall 1995 and June 1996, and future meetings are planned. Most of the teams have collected quantitative data about the current processes and have started to pilot test process changes.
在法国，对持续质量改进（CQI）及其他质量改进（QI）方法的关注是最近才有的，相关经验也较少，但鉴于政府要求所有医院在未来五年内获得认证，变革的步伐应该会加快。此外，面对日益激烈的竞争，公立和私立医院可能会发现质量战略对帮助它们生存至关重要。
1994年秋季，国家医疗评估促进机构（ANDEM）受卫生部委托，基于质量保证和CQI方法设立了一个全国示范项目。该项目旨在确定在医院内实施此类项目的关键成功因素。该项目包括28个为期18个月的CQI项目，涉及医院感染预防、麻醉患者安全、病历、输血安全、药物分发安全以及精神科环境中的暴力控制。参与项目的医院需要分析相关流程中的变异情况，并通过跨部门质量管理项目尝试减少变异。每个团队管理项目的一般方法严格遵循PDCA（计划-执行-检查-行动）循环。初步经验表明，参与项目的医院通过遵循相同模式和分享进展情况而受益。28个团队的代表在1995年秋季和1996年6月举行了会议，并计划在未来继续召开会议。大多数团队已经收集了有关当前流程的定量数据，并开始对流程变更进行试点测试。
