The Challenges of Measuring, Improving, and Reporting Quality in Primary Care
The Challenges of Measuring, Improving, and Reporting Quality in Primary Care
复制标题
衡量、提高和报告初级保健质量的挑战
作者：
R. Young;R. Roberts;R. Holden
我们提出了一套新的初级保健质量管理的优先事项，承认付款人和监管机构可能会继续坚持报告数字质量指标。初级保健实践被描述为复杂的适应系统。传统的质量改进过程适用于线性机械系统，如孤立的单一疾病护理，是不适合的非线性，复杂的适应性系统，如初级保健，因为在护理过程中的差异，结果的目标，和总结性质量记分卡的有效性。我们对初级保健质量管理的优先事项包括以患者为中心的报告;不基于刚性目标的质量目标;捕获避免过度检测或治疗的指标;与更好的结果和更低的成本相关的初级保健属性;不太强调患者满意度评分;以患者为中心的结果，例如可避免的残疾天数;同行领导的护理模式，实践基础设施和内部关系的定性审查。
We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear mechanical systems, such as isolated single-disease care, are inappropriate for nonlinear, complex adaptive systems, such as primary care, because of differences in care processes, outcome goals, and the validity of summative quality scorecards. Our priorities for primary care quality management include patient-centered reporting; quality goals not based on rigid targets; metrics that capture avoidance of excessive testing or treatment; attributes of primary care associated with better outcomes and lower costs; less emphasis on patient satisfaction scores; patient-centered outcomes, such as days of avoidable disability; and peer-led qualitative reviews of patterns of care, practice infrastructure, and intrapractice relationships.
影响因子：
--
作者：
K. Stange;S. Zyzanski;C. Jaén;E. Callahan;R. Kelly;R. Kelly;W. Gillanders;J. C. Shank;J. Chao;J. Medalie;W. Miller;B. Crabtree;S. Flocke;V. Gilchrist;D. Langa;M. Goodwin
通讯作者：
K. Stange;S. Zyzanski;C. Jaén;E. Callahan;R. Kelly;R. Kelly;W. Gillanders;J. C. Shank;J. Chao;J. Medalie;W. Miller;B. Crabtree;S. Flocke;V. Gilchrist;D. Langa;M. Goodwin
影响因子：
39
作者：
Hussey, Peter S.;Schneider, Eric C.;Rudin, Robert S.;Fox, D. Steven;Lai, Julie;Pollack, Craig Evan
通讯作者：
Pollack, Craig Evan
影响因子：
120.7
作者：
Stringhini, Silvia;Sabia, Severine;Shipley, Martin;Brunner, Eric;Nabi, Hermann;Kivimaki, Mika;Singh-Manoux, Archana
通讯作者：
Singh-Manoux, Archana