计划性质量措施:提高手术质量的新模式

Xane Peters, Jill Sage, Courtney Collins, Frank Opelka, Clifford Ko
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摘要

医疗保健绩效指标主要从结果、流程或医疗保健服务的结构性组成部分等方面进行衡量。然而,由于数据来源、定义和变通方法的不同,衡量标准受到了限制。美国外科医生学会最近开发了一种新型的绩效指标,即计划性指标。这些衡量标准将结构、流程和结果统一起来,以更好地协调质量衡量与对一线护理团队的支持。通过这种多方面的方式,这些衡量标准有别于当前的 "单一 "衡量标准,例如针对手术部位感染(SSI)的衡量标准。这些衡量标准的主题重点和结构-资源组成部分的调整以支持流程和结果,也使这些衡量标准有别于当前的综合衡量标准。重要的是,这些指标的结构要素反映了患者护理所需的最低资源,解决了地方机构在处理众多现有质量指标时所遇到的人员和资源障碍。这些指标将简化质量报告,改善患者的护理导航。临床医生将发现目标和责任更加一致,从而加强团队合作和沟通。这些措施旨在以患者为中心的方式,解决目前指标过多、优先级不统一、资源不足等问题,从而更好地调整医疗质量和衡量标准。
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Programmatic Quality Measures: A new model to promote surgical quality
Healthcare performance metrics are offered predominantly in terms of outcomes, processes, or structural components of healthcare delivery. However, measurement is limited by variability in data sources, definitions, and workarounds. The American College of Surgeons has recently developed a new type of performance metric known as a programmatic measure. These metrics align structures, processes, and outcomes to better coordinate quality measurement with support of frontline care teams. In this multifaceted way, these measures differ from current ‘single’ measures such as targeting surgical site infection (SSI). The thematic focus of these measures and alignment of structure-resource components to support processes and outcomes also sets these measures apart from contemporary composite measures. Importantly, structural elements of these measures reflect minimum resources required for patient care, addressing staffing and resource barriers felt by local institutions in addressing numerous existing quality metrics. These metrics will streamline quality reporting to improve care navigation for patients. Clinicians will find more appropriately aligned goals and responsibilities, resulting in increased teamwork and communication. These measures are designed to address the current burdens of overabundant metrics, priority misalignment, and low resources in a patient centric fashion to better align healthcare quality and measurement.
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