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首页> 外文期刊>Joint Commission Journal on Quality and Safety >Journey to Top Performance: A Multipronged Quality Improvement Approach to Reducing Cardiac Surgery Mortality
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Journey to Top Performance: A Multipronged Quality Improvement Approach to Reducing Cardiac Surgery Mortality

机译：追求卓越的旅程：降低心脏手术死亡率的多管齐下的质量改进方法

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Background: In 2006, leadership at Long Island Jewish Medical Center (New Hyde Park, New York) noted significantly higher cardiac surgery mortality rates for isolated valve and valve/coronary artery bypass graft procedures compared to the New York State Department of Health's Cardiac Surgery Reporting System statewide average. Methods: Long Island Jewish Medical Center, a 583-bed nonprofit, tertiary care teaching hospital, is one of the clinical and academic hubs of North Shore-LIJ Health System. Senior leadership launched an evaluation of the cardiac surgery program to determine why cardiac surgery mortality rates were higher than expected. As a result, the cardiac surgery program was redesigned, and interventions were implemented related to preoperative care, intraoperative monitoring, postoperative care, and the cardiac surgery quality management program. Results: According to the most recent New York State Department of Health reporting period (2009-2011), Long Island Jewish Medical Center had the lowest risk-adjusted mortality rate in New York State for adult patients undergoing surgeries to repair or replace heart valves and for adult patients in need of valve/coronary artery bypass graft surgery. The medical center has sustained significantly lower mortality rates compared to the statewide average for the past three cardiac surgery reporting periods. Conclusions: Cardiac surgery mortality rates can be significantly reduced and sustained below comparative norms when the organization is committed to clinical excellence and quality and is involved in continuously assessing organizational performance. The evaluation launched at Long Island Jewish Medical Center led to the redesign of the cardiac surgery program and prompted widespread improvement efforts and cultural change across the entire organization.
机译：背景：2006年，长岛犹太医学中心（纽约州新海德公园）的领导指出，与纽约州卫生部的心脏外科手术报告相比，孤立的瓣膜和瓣膜/冠状动脉搭桥术的心脏手术死亡率要高得多系统全州平均水平。方法：长岛犹太医学中心是一所拥有583张床的非营利性三级护理教学医院，是北岸-LIJ卫生系统的临床和学术中心之一。高级领导对心脏外科手术计划进行了评估，以确定为什么心脏外科手术死亡率高于预期。结果，重新设计了心脏手术程序，并实施了与术前护理，术中监测，术后护理和心脏手术质量管理程序相关的干预措施。结果：根据纽约州卫生部的最新报告期（2009年至2011年），长岛犹太医疗中心的成年患者接受手术修复或更换心脏瓣膜的成人患者的风险调整后死亡率最低。适用于需要瓣膜/冠状动脉搭桥手术的成年患者。与过去三个心脏手术报告期间的全州平均水平相比，该医疗中心的死亡率一直显着降低。结论：当组织致力于临床卓越和质量并参与持续评估组织绩效时，心脏手术死亡率可以显着降低并保持在比较标准之下。在长岛犹太医学中心进行的评估导致对心脏外科手术计划的重新设计，并促使整个组织进行了广泛的改善工作和文化变革。

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