Developing and Sustaining Quality Improvement Partnerships in the VA: The Colorectal Cancer Care Collaborative
Developing and Sustaining Quality Improvement Partnerships in the VA: The Colorectal Cancer Care Collaborative
复制标题
DOI：
10.1007/s11606-009-1155-x
复制
发表时间：
2010-01-01
影响因子：
5.7
通讯作者：
Provenzale, Dawn
中科院分区：
文献类型：
--
作者：
Jackson, George L.;Powell, Adam A.;Provenzale, Dawn
退伍军人事务部 (VA) 质量增强研究计划 (QUERI) 寻求在 VA 卫生服务研究人员和临床管理人员之间建立伙伴关系，目标是设计和评估干预措施，以提高 VA 卫生保健的质量。在本报告中，我们描述了一项旨在加强结直肠癌 (CRC) 护理连续性的举措，包括诊断、治疗和监测 - 结直肠癌护理协作组织 (C4)。我们描述了导致两个并行质量改进“协作组织”的过程和思维。其中涉及 (1) CRC 筛查和诊断随访以及 (2) CRC 治疗指南的一致性和及时性。此外，我们还讨论了为传播项目第一阶段所吸取的经验教训所做的持续努力，该项目最初仅在退伍军人管理局的一部分设施中进行，并扩展到整个退伍军人管理局的医疗保健系统。该倡议的描述围绕制定、维持和传播多组成部分质量改进干预措施时必须回答的关键问题进行组织。我们最后讨论了经验教训，我们相信这些经验教训适用于其他地方的类似倡议，即使它们解决了具有不同组织结构的医疗保健环境中的不同临床问题。
The Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) seeks to develop partnerships between VA health services researchers and clinical managers, with the goal of designing and evaluating interventions to improve the quality of VA health care.In the present report we describe one such initiative aimed at enhancing the continuum of colorectal cancer (CRC) care, including diagnosis, treatment and surveillance-the Colorectal Cancer Care Collaborative (C4).We describe the process and thinking that led to two parallel quality improvement "collaboratives" that addressed (1) CRC screening and diagnostic follow-up and (2) the guideline concordance and timeliness of CRC treatment. Additionally, we discuss ongoing effort to spread lessons learned during the first stages of the project, which initially occurred at only a subset of VA facilities, throughout the VA health care system. The description of this initiative is organized around key questions that must be answered when developing, sustaining and spreading multi-component quality improvement interventions.We conclude with a discussion of lessons learned that we believe would apply to similar initiatives elsewhere, even if they address different clinical issues in health care settings with different organizational structures.