CONTROLLING VARIATION IN HEALTH-CARE - A CONSULTATION FROM SHEWHART,WALTER
CONTROLLING VARIATION IN HEALTH-CARE - A CONSULTATION FROM SHEWHART,WALTER
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DOI：
10.1097/00005650-199112000-00004
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发表时间：
1991-12-01
期刊：
影响因子：
3
通讯作者：
BERWICK, DM
中科院分区：
文献类型：
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作者：
BERWICK, DM
控制意外偏差是现代工业质量管理方法的核心目标，主要基于沃尔特·A·休哈特的理论工作。随着工业质量管理技术在医疗保健中找到自己的位置，专业人士可能会因为减少差异的努力而感到威胁。理解可能会减少这种恐惧。质量控制工作中涉及的类型的变化侵蚀了质量和可靠性，并不必要地增加了成本。例如，这种不希望的变化源于对临床数据中随机噪声的误解，源于旨在支持护理的临床和支持系统的性能的不可靠性，源于不以知识或理性为基础的实践风格的习惯性差异，以及由于未能跨卫生保健系统组件的边界整合护理。质量管理努力可以成功地减少每一种形式的变化，而不会损害卫生保健专业人员的专业自主权、尊严或目标。专业人员需要接受对他们的患者和他们自己的服务中的差异的科学控制。
The control of unintended variation is an objective central to modern industrial quality managment methods, based largely on the theoretical work of Walter A. Shewhart. As industrial quality management techniques find their place in health care, professionals may feel threatened by the effort to reduce variation. Understanding may reduce this fear. Variation of the types addressed in quality control efforts erodes quality and reliability, and adds unnecessarily to costs. Such undesirable variation derives, for example, from misinterpretation of random noise in clinical data, from unreliability in the performance of clinical and support systems intended to support care, from habitual differences in practice style that are not grounded in knowledge or reason, and from the failure to integrate care across the boundaries of components of the health care system. Quality management efforts can successfully reduce each of these forms of variation without insult to the professional autonomy, dignity, or purpose of health care professionals. Professionals need to embrace the scientific control of variation in the service of their patients and themselves.