Clinical Communities at Johns Hopkins Medicine: An Emerging Approach to Quality Improvement
Clinical Communities at Johns Hopkins Medicine: An Emerging Approach to Quality Improvement
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DOI：
10.1016/s1553-7250(15)41050-5
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发表时间：
2015-09-01
影响因子：
2.3
通讯作者：
Pronovost, Peter J.
中科院分区：
文献类型：
--
作者：
Gould, Lois J.;Wachter, Patricia A.;Pronovost, Peter J.
背景资料：临床社区是一种新兴的质量改进（QI）方法，几个大型项目取得了一些成功。2011年，阿姆斯特朗患者安全与质量研究所建立了临床社区，将其作为核心战略，将来自六家不同医院的一线提供者联系起来，以提高整个医疗系统的护理质量、患者安全和价值。临床社区：建立了14个临床社区，为改进提供了巨大的机会。一个社区可以关注一个临床领域、一个患者群体、一个群体、一个过程、一个安全相关的问题，或者几乎任何一个医疗保健问题。社区的合作精神包括来自每个社区的每个医院的跨学科成员和代表。社区参与了团队建设活动，促进了讨论，每月举行会议，并鼓励他们亲自会面，以发展关系和建立信任。社区建立后，患者和家属被邀请加入并分享他们的观点和经验。使能结构：临床社区结构为临床医生提供了资源，如技术专家和安全和QI研究人员，这些资源不容易获得或可用。社区召集了来自每家医院的临床医生考虑安全问题及其解决方案，并与工作场所的同行和当地单位safety teams.Conclusion：临床社区从事195临床医生从整个卫生系统的QI项目和同行学习。挑战包括临床医生的财政支持和时间有限，及时获取数据，卫生系统的资源有限，以及没有足够的时间与改进专家。
Background: Clinical communities are an emerging approach to quality improvement (QI) to which several large-scale projects have attributed some success. In 2011 the Armstrong Institute for Patient Safety and Quality established clinical communities as a core strategy to connect frontline providers from six different hospitals to improve quality of care, patient safety, and value across the health system.Clinical Communities: Fourteen clinical communities that presented great opportunity for improvement were established. A community could focus on a clinical area, a patient population, a group, a process, a safety-related issue, or nearly any health care issue. The collaborative spirit of the communities embraced interdisciplinary membership and representation from each hospital in each community. Communities engaged in team-building activities and facilitated discussions, met monthly, and were encouraged to meet in person to develop relationships and build trust. After a community was established, patients and families were invited to join and share their perspectives and experiences.Enabling Structures: The clinical community structure provided clinicians access to resources, such as technical experts and safety and QI researchers, that were not easily otherwise accessible or available. Communities convened clinicians from each hospital to consider safety problems and their resolution and share learning with workplace peers and local unit safety teams.Conclusion: The clinical communities engaged 195 clinicians from across the health system in QI projects and peer learning. Challenges included limited financial support and time for clinicians, timely access to data, limited resources from the health system, and not enough time with improvement experts.