Ditmyer S, Koepsell B, Branum V, Davis P, Lush M T
Pediatric Department Leader, Kaiser Permanente Medical Center, Oakland, CA, USA.
J Nurs Adm. 1998 Jun;28(6):10-6. doi: 10.1097/00005110-199806000-00004.
In an era of rapidly shifting resources and changing models of care, healthcare providers must demonstrate quality and cost-effective patient care. Historically, quality of care has been described using administrative variables such as mortality, morbidity, length of stay, readmissions, and cost. Methods have not been readily available to define quality in terms of the effect of care delivery on the health of patients. Combined administrative and health-related databases are foundational to outcome infrastructures evolving with the electronic medical record. Nursing leaders in a large health maintenance organization sponsored the development of the Health Status Outcome Dimensions (HSOD) instrument. The HSOD instrument includes measures of functional status, knowledge, and engagement in healthcare and the patient and family psychosocial well-being. This article describes the processes used and the challenges faced in the development of the HSOD instrument. The current status of the HSOD instrument is described, as well as its planned future development.
在一个资源迅速转移和护理模式不断变化的时代,医疗保健提供者必须展示高质量且具有成本效益的患者护理。从历史上看,护理质量一直是用诸如死亡率、发病率、住院时间、再入院率和成本等管理变量来描述的。一直以来,尚未有现成的方法能根据护理提供对患者健康的影响来界定质量。行政数据库与健康相关数据库相结合,是随着电子病历不断发展的结果基础设施的基础。一家大型健康维护组织的护理领导者发起了健康状况结果维度(HSOD)工具的开发。HSOD工具包括功能状态、知识以及医疗保健参与度的衡量指标,还有患者及其家庭的心理社会幸福感。本文描述了开发HSOD工具所采用的流程以及面临的挑战。还介绍了HSOD工具的当前状态及其未来的计划发展。