军民合作质量改进计划概念:改进数据收集和成果评估的程序。

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Military Medicine Pub Date : 2024-11-05 DOI:10.1093/milmed/usae117
Justin P Fox, Ryan E Earnest, Valerie Sams
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引用次数: 0

摘要

导言:军民合作(MCP)对于保持军队医疗保健医生的部署准备状态至关重要。然而,跟踪他们的临床活动已被证明具有挑战性。在本研究中,我们介绍了一种由地方驱动的流程,旨在被动收集外部临床工作量数据。该流程旨在促进对 MCP 医生的部署准备情况和单个 MCP 的有效性进行评估:从 2020 年 3 月到 2023 年 2 月,我们在莱特帕特森医疗中心(WPMC)开展了一系列质量改进项目,以加强对 MCP 医生的数据收集工作。我们的方法包括几个步骤。首先,我们评估了现有的数据收集流程及其结果,以确定需要改进的地方。接下来,我们测试了各种数据收集方法,包括自我报告、基于网络的智能手机应用程序以及基于账单或电子健康记录数据的自动化流程。随后,我们改进了数据收集流程,纳入了已确定的改进措施,并对结果进行了系统跟踪。最后,我们在两家不同的医疗保健中心对改进后的流程进行了评估,主要结果指标是每月医疗保健数据的收集情况:在对 WPMC 的检查中,我们初步发现了在数据收集工作中存在的几个薄弱环节。其中包括医疗小组内部数据收集责任不明确、参与 MCP 的医生名册不足以及未充分利用军队和社区资源进行数据收集。为解决这些问题,我们对数据收集流程进行了修订。这些修订包括通过军民合作办公室明确数据收集的责任,采用定期 "点名 "的方式将医生与 MCP 协议相匹配,每月通过民事合作伙伴的账单或信息技术办公室被动收集数据,以及将军民合作办公室的工作纳入执行委员会的定期会议。结果,我们发现 WPMC 的每月数据采集量增加了 4 倍,在空军创伤和战备技能维持中心实施改进后的流程时也取得了类似的成果:军民合作质量改进计划概念是一种有效的、由地方推动的流程,可加强参与军民合作计划的军队医疗服务提供者的外部临床工作量数据采集。需要在其他机构对军民合作质量改进计划流程进行进一步检查,以验证其有效性并建立一个军民合作质量改进计划倡导者社区。
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The Military-Civilian Partnership Quality Improvement Program Concept: A Process to Improve Data Collection and Outcomes Assessment.

Introduction: Military-Civilian Partnerships (MCPs) are vital for maintaining the deployment readiness of military health care physicians. However, tracking their clinical activity has proven to be challenging. In this study, we introduce a locally driven process aimed at the passive collection of external clinical workload data. This process is designed to facilitate an assessment of MCP physicians' deployment readiness and the effectiveness of individual MCPs.

Materials and methods: From March 2020 to February 2023, we conducted a series of quality improvement projects at the Wright Patterson Medical Center (WPMC) to enhance our data collection efforts for MCP physicians. Our methodology encompassed several steps. First, we assessed our existing data collection processes and their outcomes to identify improvement areas. Next, we tested various data collection methods, including self-reporting, a web-based smart phone application, and an automated process based on billing or electronic health record data. Following this, we refined our data collection process, incorporating the identified improvements and systematically tracking outcomes. Finally, we evaluated the refined process in 2 different MCPs, with our primary outcome measure being the collection of monthly health care data.

Results: Our examination at the WPMC initially identified several weaknesses in our established data collection efforts. These included unclear responsibility for data collection within the Medical Group, an inadequate roster of participating MCP physicians, and underutilization of military and community resources for data collection. To address these issues, we implemented revisions to our data collection process. These revisions included establishing clear responsibility for data collection through the Office of Military-Civilian Partnerships, introducing a regular "roll call" to match physicians to MCP agreements, passively collecting data each month through civilian partner billing or information technology offices, and integrating Office of Military-Civilian Partnership efforts into regular executive committee meetings. As a result, we observed a 4-fold increase in monthly data capture at WPMC, with similar gains when the refined process was implemented at an Air Force Center for the Sustainment of Trauma and Readiness Skills site.

Conclusions: The Military-Civilian Partnership Quality Improvement Program concept is an effective, locally driven process for enhancing the capture of external clinical workload data for military providers engaged in MCPs. Further examination of the Military-Civilian Partnership Quality Improvement Program process is needed at other institutions to validate its effectiveness and build a community of MCP champions.

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来源期刊
Military Medicine
Military Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
2.20
自引率
8.30%
发文量
393
审稿时长
4-8 weeks
期刊介绍: Military Medicine is the official international journal of AMSUS. Articles published in the journal are peer-reviewed scientific papers, case reports, and editorials. The journal also publishes letters to the editor. The objective of the journal is to promote awareness of federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members’ writings.
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