Fox C H, Mahoney M C
Department of Family Medicine, State University of New York at Buffalo, USA.
Fam Med. 1998 Jun;30(6):441-5.
The paradigm of continuous quality improvement (CQI) holds promise for application in clinical settings. This paper highlights results of a CQI project developed and implemented in a residency-based, ambulatory family medicine center for management of non-insulin-dependent diabetes mellitus.
We developed a CQI program that used several indicators of diabetes management as measures of quality care. These included dietary counseling, exercise counseling, foot care counseling, ophthalmology referral, and measurement of hemoglobin AIC and renal function.
Overall, compliance with recommendations for diabetes management increased from a baseline proportion of 40% to a level of 70% at the end of 1 year. During the second year, overall compliance was maintained at this level despite the inclusion of additional performance indicators.
The CQI process can improve physician performance in managing patients with diabetes.
持续质量改进（CQI）模式有望应用于临床环境。本文重点介绍了在一家以住院医师为主的门诊家庭医学中心开展并实施的一项CQI项目，该项目用于管理非胰岛素依赖型糖尿病。
我们制定了一个CQI计划，该计划使用了几个糖尿病管理指标作为优质护理的衡量标准。这些指标包括饮食咨询、运动咨询、足部护理咨询、眼科转诊以及糖化血红蛋白和肾功能的测量。
总体而言，表示糖尿病管理建议的依从性从基线比例40%提高到1年末的70%。在第二年，尽管纳入了更多的绩效指标，但总体依从性仍维持在这一水平。
CQI过程可以提高医生管理糖尿病患者的绩效。
