Hospital quality indicators

尽管临床医生的知识和实践对高质量的护理很重要，但越来越多的情况是，医疗保健专业人员在医疗团体或医疗系统中执业。这些系统在预防错误、协调不同环境和从业人员之间的护理以及确保在需要时提供相关、准确的信息方面的运作，是提供高质量护理的关键系统要素。拟议的研究将评估医院质量改进结构和实践与854+医院样本中选定的质量指标之间的关系。两个具体的研究目标是先进的：（1）评估医院质量改进基础设施和质量指标之间的关联在医院一级;（2）确定组织和市场条件下，具体的质量改进措施影响质量指标在医院一级。该研究将结合联合收割机独特的调查数据，医院质量改进的结构和做法的数据来自医院出院摘要数据根据HCUP计划在AHRQ。使用多元统计分析，我们将检查的范围，持续时间和强度的医院QI实施对医院级临床质量指标的主要影响。该研究还将研究如何领导质量，组织基础设施和资源的质量，以及其他组织和市场特征温和的医院QI实践和医院级临床质量指标之间的关系。研究结果将为政策制定者、认证机构和消费者提供更精确的信息，即医院QI的哪些维度与选定的医院质量指标表现出最强的关联。因此，研究结果可能提供质量改进标准和基准的基础，不仅强调广泛可用的质量指标，而且还强调那些可能适合QI干预医院管理者和临床医生的指标。第二，在某种程度上，我们的研究结果确定的条件下，特定的方法来提高医院质量与更积极的质量指标，医院可能能够针对这些战略，特别是适合他们的经营环境。

Although the knowledge and practices of individual clinicians are important for high quality care, it is increasingly the case that health care professionals practice within groups or systems of care. The functioning of those systems in preventing errors, coordinating care among settings and practitioners, and ensuring that relevant, accurate information is available when needed are critical systemic elements of providing high quality care. The proposed study will assess the relationship between hospital quality improvement structures and practices and selected quality indicators in a sample of 854+ hospitals. Two specific study objectives are advanced: (1) to assess the association between hospital quality improvement infrastructure and quality indicators at the hospital level; and (2) to identify the organizational and market conditions under which specific quality improvement practices affect quality indicators at the hospital level. The study will combine unique survey data on hospital quality improvement structures and practices with data derived from hospital discharge abstract data under the HCUP program at AHRQ. Using multivariate statistical analyses, we will examine the main effects of the scope, duration and intensity of hospital QI implementation on hospital-level clinical quality indicators. The study will also examine how leadership for quality, organizational infrastructure and resources for quality, and other organizational and market characteristics moderate the relationship between hospital QI practices and hospital-level clinical quality indicators. Study results will provide policy makers, accrediting bodies, and consumers with more precise information regarding which dimensions of hospital QI exhibit the strongest association with select hospital quality indicators. Study findings may therefore provide the basis for quality improvement standards and benchmarks that emphasize not only widely available quality indicators but also those indicators that are potentially amenable to QI interventions by hospital managers and clinicians. Second, To the extent that our study findings identify the conditions under which particular approaches to hospital quality improvement are associated with more positive quality indicators, hospitals may be able to target those strategies that are particularly suited to their operating environment.