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首页> 美国卫生研究院文献>BMJ Open Quality >Quality improvement education to improve performance on ulcerative colitis quality measures and care processes aligned with National Quality Strategy priorities
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Quality improvement education to improve performance on ulcerative colitis quality measures and care processes aligned with National Quality Strategy priorities

机译：进行质量改进教育以改善溃疡性结肠炎质量措施和护理过程的绩效以符合国家质量战略的重点

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Studies on inflammatory bowel disease (IBD) have reported suboptimal approaches to patient care. In the United States, the findings have motivated leading gastroenterology organizations to call for initiatives that support clinicians in aligning their practices with quality measures for IBD and priorities of the National Quality Strategy (NQS).We designed and implemented a quality improvement (QI) education program on ulcerative colitis in which patient charts were audited for 30 gastroenterologists before (n = 300 charts) and after (n = 290 charts) they participated in QI-focused educational activities. Charts were audited for nine measures, selected for their alignment with four NQS priorities: making care safer, ensuring patient engagement, promoting communication, and promoting effective treatment practices. Four of the measures, including guideline-directed vaccinations and assessments of disease type and activity, were part of the CMS Physician Quality Reporting System (PQRS). The other five measures involved counseling patients on various topics in ulcerative colitis management, documentation of side effects, assessment of adherence status, and simplification of dosing. The gastroenterologists also completed baseline and post-education surveys designed to assess qualitative outcomes.One of the educational interventions was a private audit feedback session conducted for each gastroenterologist. The sessions were designed to support participants in identifying measures reflecting suboptimal care quality and developing action plans for improvement. In continuous improvement cycles, follow-up interventions included QI tools and educational monographs.Across the nine chart variables, post-education improvements ranged from 0% to 48%, with a mean improvement of 15.9%. Survey findings revealed improvements in self-reported understanding of quality measures and intentions to apply them to practice, and lower rates of perceived significant barriers to high-quality care. The findings indicate the potential for QI education to support gastroenterologists in improving their performance on key measures of care quality for patients with ulcerative colitis.
机译：关于炎症性肠病（IBD）的研究已经报告了患者护理的最佳方法。在美国，这项发现激励着领先的肠胃病学组织呼吁采取行动，支持临床医生将其实践与IBD的质量措施和《国家质量战略》（NQS）的重点相结合。我们设计并实施了质量改进（QI）教育溃疡性结肠炎计划，其中30位胃肠病医生在参加QI之前的教育活动之前（n = 300图表）和之后（n = 290图表）接受了患者图表的审查。对图表进行了审核，以选择九种措施，以使其与NQS的四个优先事项保持一致：提高护理质量，确保患者参与，促进沟通以及促进有效的治疗方法。 CMS医师质量报告系统（PQRS）的其中四项措施，包括指导性疫苗接种和疾病类型和活动评估。其他五项措施包括在溃疡性结肠炎管理，副作用记录，依从性评估以及简化剂量等方面为患者提供咨询。肠胃科医生还完成了旨在评估质量结果的基线和后期教育调查。教育干预措施之一是为每位肠胃科医生进行一次私人审核反馈会议。这些会议旨在支持参与者确定反映最佳护理质量的措施并制定改善行动计划。在持续改进周期中，后续干预措施包括QI工具和教育专着。在9个图表变量中，教育后改进范围从0％到48％，平均改进15.9％。调查结果表明，自我报告的对质量措施的了解有所提高，并表明了将其应用于实践的意图，并且降低了对高质量护理的重大障碍的感知率。研究结果表明，QI教育有可能支持胃肠病医生改善溃疡性结肠炎患者护理质量关键指标的绩效。

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