Implementing a state-based stroke quality improvement collaborative: the Massachusetts experience.
Implementing a state-based stroke quality improvement collaborative: the Massachusetts experience.
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实施基于州的卒中质量改善协作：马萨诸塞州的经验。
DOI：
10.1097/hpc.0b013e31825e12a6
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发表时间：
2012
影响因子：
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通讯作者：
Schwamm,LeeH
中科院分区：
文献类型：
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作者：
O'Neill,HJune;Coe,LauraJ;Magdon-Ismail,Zainab;Schwamm,LeeH
背景：追求卓越中风协作组织是一项自愿性中风质量改善 (QI) 协作组织，由马萨诸塞州公共卫生部和美国心脏协会/美国中风协会合作领导。自 2005 年以来，该合作机构根据国家临床指南，协助马萨诸塞州初级中风服务医院提高急性中风护理的质量。我们为寻求建立公私合作伙伴关系以促进医院中风 QI 的各州提供了总体概述。方法：基于医疗保健改进研究所的合作模式，该计划招募了医院，培训数据收集人员，并提供临床 QI 专业知识。为了评估该模型在医院参与方面的成功程度，我们使用描述性统计数据计算了参与率和病例录入率的变化。结果：从 2005 年到 2010 年，70 家初级卒中服务医院中有 58 家（83%）参与了合作，占全州年度卒中出院量的 85% 以上。平均而言，74% 的医院代表参加了学习课程，55% 的医院代表参加了数据质量电话会议，54% 的医院代表参加了区域会议。从 2007 年到 2010 年，有超过 39,000 例病例被登记，从 2007 年（平均值，171±136；n= 9425）到 2010 年（平均值，197±143；n= 10,809）增加了 15%。 结论：一致的参与和病例登记证实自愿的州级医院 QI 协作是可行和可持续的。这是在医院缺乏持续资助的情况下发生的。需要进一步的研究来确定项目参与和改善患者护理之间的关系以及模型的普遍性。
Background:The Stroke Collaborative Reaching for Excellence is a voluntary stroke quality improvement (QI) collaborative led by a partnership between the Massachusetts Department of Public Health and the American Heart Association/American Stroke Association. Since 2005, the collaborative has assisted Massachusetts Primary Stroke Service hospitals in improving the quality of acute stroke care based on national clinical guidelines. We provide a general overview for states seeking to establish a public-private partnership to promote hospital stroke QI.Methods:Based on the Institute for Healthcare Improvement’s Collaborative model, the program enrolled hospitals, trained staff in data collection, and provided expertise on clinical QI. To assess the success of the model at engaging hospitals, rates of change in participation and case entry were calculated with descriptive statistics.Results:From 2005 to 2010, 58 of 70 (83%) Primary Stroke Service hospitals participated in the collaborative, accounting for over 85% of the statewide annual stroke discharges. On average, 74% of hospital representatives attended learning sessions, 55% participated in data quality conference calls, and 54% attended regional meetings. Over 39,000 cases were entered into the registry from 2007 to 2010, with a 15% increase from 2007 (mean, 171±136; n= 9425) to 2010 (mean, 197±143; n= 10,809).Conclusion:Consistent participation and case entry confirm that a voluntary state-based hospital QI collaborative is feasible and sustainable. This occurred in the absence of continued hospital funding. Further research is needed to identify the relationship between program participation and improved patient care and the generalizability of the model.