优化艾滋病毒护理连续体的干预措施:使用过程改进分析的案例研究

IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Operations Research for Health Care Pub Date : 2020-06-01 DOI:10.1016/j.orhc.2020.100258
Geoffrey J. Barrow , Michael Fairley , Margaret L. Brandeau
{"title":"优化艾滋病毒护理连续体的干预措施:使用过程改进分析的案例研究","authors":"Geoffrey J. Barrow ,&nbsp;Michael Fairley ,&nbsp;Margaret L. Brandeau","doi":"10.1016/j.orhc.2020.100258","DOIUrl":null,"url":null,"abstract":"<div><p>UNAIDS’ 90–90–90 goal for 2020 is for 90% of HIV-infected people to know their status, 90% of infected individuals to receive antiretroviral therapy (ART), and 90% of those on ART to achieve viral suppression. To achieve these ambitious goals, effective care delivery programs are needed. In this paper we present a case study showing how HIV care can be improved by viewing the patient care process as a production process and applying methods of process improvement analysis. We examine the continuum of HIV care at a hospital-based HIV clinic in Kingston, Jamaica. We perform qualitative analysis to identify key programmatic, personnel, and clinical areas for process improvement. We then perform quantitative analysis. We develop a stochastic model of the care process which we use to evaluate the effects of potential process improvements on the number of patients who receive ART and the number who achieve viral suppression. We also develop a model for optimal investment of a fixed budget among interventions aimed at improving the care cascade and we use the model to determine the optimal investment among three interventions that the clinic could invest in. By viewing the patient care process as a production process and applying qualitative and quantitative process improvement analysis, our case study illustrates how clinics can identify the best ways to maximize clinical outcomes. Our methods are generalizable to other HIV care clinics as well as to clinics that provide care for other chronic conditions (e.g., diabetes, hepatitis B, or opioid use disorder).</p></div>","PeriodicalId":46320,"journal":{"name":"Operations Research for Health Care","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.orhc.2020.100258","citationCount":"4","resultStr":"{\"title\":\"Optimizing interventions across the HIV care continuum: A case study using process improvement analysis\",\"authors\":\"Geoffrey J. Barrow ,&nbsp;Michael Fairley ,&nbsp;Margaret L. Brandeau\",\"doi\":\"10.1016/j.orhc.2020.100258\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>UNAIDS’ 90–90–90 goal for 2020 is for 90% of HIV-infected people to know their status, 90% of infected individuals to receive antiretroviral therapy (ART), and 90% of those on ART to achieve viral suppression. To achieve these ambitious goals, effective care delivery programs are needed. In this paper we present a case study showing how HIV care can be improved by viewing the patient care process as a production process and applying methods of process improvement analysis. We examine the continuum of HIV care at a hospital-based HIV clinic in Kingston, Jamaica. We perform qualitative analysis to identify key programmatic, personnel, and clinical areas for process improvement. We then perform quantitative analysis. We develop a stochastic model of the care process which we use to evaluate the effects of potential process improvements on the number of patients who receive ART and the number who achieve viral suppression. We also develop a model for optimal investment of a fixed budget among interventions aimed at improving the care cascade and we use the model to determine the optimal investment among three interventions that the clinic could invest in. By viewing the patient care process as a production process and applying qualitative and quantitative process improvement analysis, our case study illustrates how clinics can identify the best ways to maximize clinical outcomes. Our methods are generalizable to other HIV care clinics as well as to clinics that provide care for other chronic conditions (e.g., diabetes, hepatitis B, or opioid use disorder).</p></div>\",\"PeriodicalId\":46320,\"journal\":{\"name\":\"Operations Research for Health Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2020-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.orhc.2020.100258\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Operations Research for Health Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2211692320300382\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operations Research for Health Care","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2211692320300382","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 4

摘要

联合国艾滋病规划署2020年的“90-90-90”目标是使90%的艾滋病毒感染者了解自己的状况,90%的感染者接受抗逆转录病毒治疗,90%接受抗逆转录病毒治疗的人实现病毒抑制。为了实现这些雄心勃勃的目标,需要有效的医疗服务规划。在本文中,我们提出了一个案例研究,展示了如何通过将患者护理过程视为生产过程并应用过程改进分析方法来改善艾滋病毒护理。我们在牙买加金斯敦的一家医院艾滋病毒诊所检查了艾滋病毒护理的连续性。我们执行定性分析,以确定关键的程序、人员和临床领域的过程改进。然后进行定量分析。我们开发了一个护理过程的随机模型,我们用它来评估潜在的过程改进对接受抗逆转录病毒治疗的患者数量和实现病毒抑制的患者数量的影响。我们还开发了一个模型,用于在旨在改善护理级联的干预措施中进行固定预算的最佳投资,我们使用该模型来确定诊所可以投资的三种干预措施中的最佳投资。通过将患者护理过程视为生产过程并应用定性和定量过程改进分析,我们的案例研究说明了诊所如何确定最大化临床结果的最佳方法。我们的方法可推广到其他HIV护理诊所以及提供其他慢性疾病护理的诊所(例如,糖尿病,乙型肝炎或阿片类药物使用障碍)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Optimizing interventions across the HIV care continuum: A case study using process improvement analysis

UNAIDS’ 90–90–90 goal for 2020 is for 90% of HIV-infected people to know their status, 90% of infected individuals to receive antiretroviral therapy (ART), and 90% of those on ART to achieve viral suppression. To achieve these ambitious goals, effective care delivery programs are needed. In this paper we present a case study showing how HIV care can be improved by viewing the patient care process as a production process and applying methods of process improvement analysis. We examine the continuum of HIV care at a hospital-based HIV clinic in Kingston, Jamaica. We perform qualitative analysis to identify key programmatic, personnel, and clinical areas for process improvement. We then perform quantitative analysis. We develop a stochastic model of the care process which we use to evaluate the effects of potential process improvements on the number of patients who receive ART and the number who achieve viral suppression. We also develop a model for optimal investment of a fixed budget among interventions aimed at improving the care cascade and we use the model to determine the optimal investment among three interventions that the clinic could invest in. By viewing the patient care process as a production process and applying qualitative and quantitative process improvement analysis, our case study illustrates how clinics can identify the best ways to maximize clinical outcomes. Our methods are generalizable to other HIV care clinics as well as to clinics that provide care for other chronic conditions (e.g., diabetes, hepatitis B, or opioid use disorder).

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Operations Research for Health Care
Operations Research for Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.90
自引率
0.00%
发文量
9
审稿时长
69 days
期刊最新文献
Editorial Board Preference-based allocation of patients to nursing homes Balancing continuity of care and home care schedule costs using blueprint routes Outpatient appointment systems: A new heuristic with patient classification A modeling framework for evaluating proactive and reactive nurse rostering strategies — A case study from a Neonatal Intensive Care Unit
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1