Part 4: Systems of Care and Continuous Quality Improvement 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Part 4: Systems of Care and Continuous Quality Improvement 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
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DOI：
10.1161/cir.0000000000000258
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发表时间：
2015-11-03
期刊：
影响因子：
37.8
通讯作者：
Welsford, Michelle
中科院分区：
文献类型：
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作者：
Kronick, Steven L.;Kurz, Michael C.;Welsford, Michelle
在2015年美国心脏协会（AHA）心脏复苏（CPR）和紧急心血管护理（ECC）指南更新的其他部分中讨论的科学和建议构成了复苏的支柱。他们回答执行复苏步骤的“为什么”、“什么”和“何时”。在一个完全受控和可预测的环境中，如实验室环境，这些答案往往就足够了，但实际实施的“如何”还取决于知道“谁”和“在哪里”。成功完成复苏的理想工作流程高度依赖于整个护理系统。医疗保健服务需要结构（例如，人员、设备、教育、前瞻性登记数据收集）和过程（例如，政策、方案、程序），当它们整合时，会产生一个系统（例如，计划、组织、文化），从而产生结果（例如，患者安全、质量、满意度）。一个有效的护理系统（图1）包括所有这些元素的结构，过程，系统和病人的结果，在持续质量改进（CQI）的框架。
The science and recommendations discussed in the other Parts of the 2015 American Heart Association (AHA) Guidelines Update for Cardiopulmonary Resuscitation (CPR) andEmergency Cardiovascular Care (ECC) form the backbone of resuscitation. They answer the “why”,“what,” and “when” of performing resuscitation steps. In a perfectly controlled and predictable environment, such as a laboratory setting, those answers often suffice, but the “how” of actual implementation depends on knowing the “who” and “where” as well. The ideal work flow to accomplish resuscitation successfully is highly dependent on the system of care as a whole. Healthcare delivery requires structure (eg, people, equipment, education, prospective registry data collection) and process (eg, policies, protocols, procedures), which, when integrated, produce a system (eg, programs, organizations, cultures) leading to outcomes (eg, patient safety, quality, satisfaction). An effective system of care (Figure 1) comprises all of these elements—structure, process, system, and patient outcomes—in a framework of continuous quality improvement (CQI).