The measurement of quality of care in the Veterans Health Administration.
The measurement of quality of care in the Veterans Health Administration.
复制标题
退伍军人健康管理局护理质量的衡量。
作者：
J. Halpern
退伍军人健康管理局（VHA）致力于不断完善其质量测量系统。VHA质量测量的组织结构有三个层次。在国家一级，负责质量管理的副首席医疗主任提供领导，制定政策，使用测量工具，制定和分发质量措施，并提供教育计划。在中级层面，VHA有四个区域办事处，其工作人员负责审查风险管理数据，调查质量问题，并确保符合认证要求。在医院一级，直接向办公室主任或医院院长报告的工作人员负责执行VHA质量管理政策。退伍军人健康管理局的质量衡量哲学承认该机构的道德责任，为美国退伍军人提供符合公认标准的护理。由于修复故障系统比识别表现不佳的系统更有效，VHA将全面质量技术整合到一个多方面的改进计划中，该计划还包括认证计划和传统的质量保证活动。VHA通过维护不良事件数据库，进行患者满意度调查，每年对50，000份记录进行外部同行评审，并在内部比较过程和结果率，并在可能的情况下与外部基准进行比较来监控其绩效。VHA的近期目标包括为医疗中心提供一个质量矩阵，该矩阵将允许本地开发质量指标，为VHA的客户构建报告卡，并实施Malcolm W。波多里奇质量改进体系作为全系统持续改进的路线图。其他目标包括提供更多的数据访问，创建以患者为中心的数据库，提供实时临床决策支持，以及扩展数据库。
The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the databases.