Joint commission plans for clinical indicator development for oncology
Joint commission plans for clinical indicator development for oncology
复制标题
肿瘤学临床指标开发联合委员会计划
作者：
R. Marder
医疗机构变革议程认证联合委员会的主要目标之一是建立一个基于临床和组织绩效指标的持续监测系统。该系统的目的是允许医疗机构和联合委员会在现场调查期间监测组织关键业务的护理趋势。该系统将向保健组织提供比较业绩数据，使它们能够更有效地集中注意在提供优质保健方面需要改进的领域。联合委员会将利用这一信息，在随后的调查和认证过程中将其评价重点放在指标所强调的领域，并评价卫生保健组织对指标数据的反应。因此，联合委员会努力制定临床指标的目的是提供一种更好的调查和认证保健组织的手段。那么，从联合委员会的角度来看，什么是临床指标？一个可操作的定义是，临床指标是对病人护理的一个方面的定量衡量，可用作监测和评价提供保健服务的质量和适当性的指南。然而，必须注意一些重要的警告。首先，临床指标本身并不是质量的直接衡量标准；它只是一个屏幕或标志，指示需要更详细分析的区域。联合委员会的重点不在于指标数据本身，而在于医院用来调查指标数据并对其作出适当反应的结构和程序。其次，指标数据的所有差异并不一定表明存在“问题”。这是“风险调整”或“疾病严重程度”的领域
NE OF THE MAJOR GOALS of the Joint Commission 0 on Accreditation of Healthcare Organizations’ Agenda for Change is to establish an ongoing monitoring system based on indicators of clinical and organizational performance.’ The purpose of this system is to allow both health care organizations and the Joint Commission to monitor trends of care across key operations of an organization between times of on-site surveys. The system will provide the health care organizations with comparative performance data and allow them to focus more eflectively on areas which need improvement in the delivery of quality care. The Joint Commission would utilize this informalion to focus its evaluation in subsequent survey and accreditation processes to those areas highlighted by the indicators and evaluate the health care organization’s response to the indicator data. Thus, the purpose of the Joint Commission’s efforts to develop clinical indicators is to provide a better means of surveying and accrediting health care organizations. What then is a clinical indicator from the prospective of the Joint Commission? An operational definition is that a clinical indicator is a quantative measure of an aspect of patient care which can be used as a guide to monitor and evaluate the quality and appropriateness of health care delivery. Some important caveats, however, must be noted. First, a clinical indicator as such is not a direct measure of quality; it is merely a screen or flag indicating areas which require more detailed analysis. The focus of the Joint Commission is not so much on the indicator data per se, but on the structures and processes that the hospital uses to investigate indicator data and respond appropriately to it. Second, all variances in indicator data do not necessarily indicate a “problem.” This is the area in which “risk adjustment” or “severity of ill-