Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration.
Factors affecting the use of patient survey data for quality improvement in the Veterans Health Administration.
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DOI：
10.1186/1472-6963-11-334
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发表时间：
2011-12-12
影响因子：
2.8
通讯作者：
Cleary PD
中科院分区：
文献类型：
--
作者：
Davies EA;Meterko MM;Charns MP;Seibert ME;Cleary PD
关于如何利用患者反馈来改善医疗保健体验，人们知之甚少。退伍军人健康管理局(VA)定期进行患者调查，表明过去十年的护理体验有所改善。这项研究的目的是评估阻碍或促进努力改善退伍军人医院护理体验的因素。我们在两个退伍军人医院进行了案例研究，其中一个在2002至2006年间的住院患者情感支持报告中得分稳定高，另一个在同一时期得分稳定低。半结构化访谈被用来从在研究设施处理患者调查数据的工作人员那里收集信息。使用先前制定的定性框架对数据进行了分析，该框架描述了组织、专业和与数据有关的障碍和数据使用的推动者。受访者报告说，使用调查数据的推动者多于障碍，尤其是对改进努力的支持。主题包括发展以患者为中心的文化，质量改进结构，如定期数据审查，以及培训员工以患者为中心的行为。激励的影响，护理领导的作用，以及将调查数据与其他数据进行三角测量对患者的看法也变得重要。与过去相比，现在更容易收集关于当前组织和做法的数据，这使得很难推断哪些因素可能影响不同的设施业绩。对退伍军人管理局工作人员的访谈提供了一些令人振奋的例子，说明如何将使用调查数据的系统程序作为更广泛的质量改进工作的一部分加以实施。然而，需要前瞻性研究来确定使用患者反馈来改善以患者为中心的护理的特定方面的最有效策略。
Little is known about how to use patient feedback to improve experiences of health care. The Veterans Health Administration (VA) conducts regular patient surveys that have indicated improved care experiences over the past decade. The goal of this study was to assess factors that were barriers to, or promoters of, efforts to improve care experiences in VA facilities. We conducted case studies at two VA facilities, one with stable high scores on inpatient reports of emotional support between 2002 and 2006, and one with stable low scores over the same period. A semi-structured interview was used to gather information from staff who worked with patient survey data at the study facilities. Data were analyzed using a previously developed qualitative framework describing organizational, professional and data-related barriers and promoters to data use. Respondents reported more promoters than barriers to using survey data, and particularly support for improvement efforts. Themes included developing patient-centered cultures, quality improvement structures such as regular data review, and training staff in patient-centered behaviors. The influence of incentives, the role of nursing leadership, and triangulating survey data with other data on patients' views also emerged as important. It was easier to collect data on current organization and practice than those in the past and this made it difficult to deduce which factors might influence differing facility performance. Interviews with VA staff provided promising examples of how systematic processes for using survey data can be implemented as part of wider quality improvement efforts. However, prospective studies are needed to identify the most effective strategies for using patient feedback to improve specific aspects of patient-centered care.
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影响因子：
3.8
作者：
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通讯作者：
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作者：
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通讯作者：
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作者：
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通讯作者：
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