National initiatives to promote quality of care and patient safety: achievements to date and challenges ahead.
National initiatives to promote quality of care and patient safety: achievements to date and challenges ahead.
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DOI：
10.1186/s13584-020-00417-x
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发表时间：
2020-11-05
影响因子：
4.5
通讯作者：
Dreiher J
中科院分区：
文献类型：
--
作者：
Dreiher D;Blagorazumnaya O;Balicer R;Dreiher J
以色列的医疗保健质量被认为是“高”的，这一成就归功于医疗保健系统的结构和组织。本综述的目的是描述以色列医疗保健系统质量改进的主要成就和挑战。近年来，卫生部在增加公众获得质量、财务和病人满意度方面的比较数据方面取得了重大进展。多个层面的几种机制有助于促进质量改进和患者安全。这些措施包括立法，财政激励措施和国家质量指标，患者体验，患者安全，预防和控制感染和认证计划。多年来，质量指标、感染预防和患者满意度方面的改善可以证明，但其他领域几乎没有变化。挑战和障碍包括工会的不情愿、信息流不一致和不可靠、担心管理层的压力过大和医生失去自主权，以及对数据“游戏”的怀疑。认证有其自身的挑战，例如需要根据医疗保健系统的当地特点进行调整，成本高，以及其对质量影响的证据有限。领导者缺乏兴趣，缺乏资源，倦怠和同情疲劳被列为改善患者体验的挑战。以色列正在作出重大努力，利用良好的数据了解哪些措施有效，哪些措施需要特别注意，以此提高护理质量。政府和卫生保健提供者有继续改进的工具。然而，应更深入和有效地实施若干提高护理质量的机制，如最大限度地减少保健差距、质量培训和广泛实施“明智选择”倡议。
The quality of healthcare in Israel is considered “high”, and this achievement is due to the structure and organization of the healthcare system. The goal of the present review is to describe the major achievements and challenges of quality improvement in the Israeli healthcare system. In recent years, the Ministry of Health has made major strides in increasing the public’s access to comparative data on quality, finances and patient satisfaction. Several mechanisms at multiple levels help promote quality improvement and patient safety. These include legislation, financial incentives, and national programs for quality indicators, patient experience, patient safety, prevention and control of infection and accreditation. Over the years, improvements in quality indicators, infection prevention and patient satisfaction can be demonstrated, but other fields show little change, if at all. Challenges and barriers include reluctance by unions, inconsistent and unreliable flow of information, the fear of overpressure by management and the loss of autonomy by physicians, and doubts regarding “gaming” of data. Accreditation has its own challenges, such as the need to adjust it to local characteristics of the healthcare system, its high cost, and the limited evidence of its impact on quality. Lack of interest by leaders, lack of resources, burnout and compassion fatigue, are listed as challenges for improving patient experience. Substantial efforts are being made in Israel to improve quality of care, based on the use of good data to understand what is working and what needs particular attention. Government and health care providers have the tools to continue to improve. However, several mechanisms for improving the quality of care, such as minimizing healthcare disparities, training for quality, and widespread implementation of the “choosing wisely” initiative, should be implemented more intensively and effectively.
影响因子：
3.7
作者：
Spitzer-Shohat S;Shadmi E;Goldfracht M;Key C;Hoshen M;Balicer RD
通讯作者：
Balicer RD
影响因子：
4.5
作者：
Abu-Saad, Kathleen;Avni, Shlomit;Kalter-Leibovici, Ofra
通讯作者：
Kalter-Leibovici, Ofra