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首页> 外文期刊>Current opinion in anaesthesiology >Quality assessment by external bodies: intended and unintended impact on healthcare delivery.
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Quality assessment by external bodies: intended and unintended impact on healthcare delivery.

机译：外部机构的质量评估：对医疗服务的预期和非预期影响。

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摘要

PURPOSE OF REVIEW: External quality assessment programs in the form of pay for performance, report cards and national rankings are rapidly overtaking more traditional, internal quality assessment efforts and external clinical practice guidelines. Although such initiatives are designed to improve healthcare quality by promoting competition and increasing transparency, review of their efficacy and unintended effects is just coming to the national spotlight. RECENT FINDINGS: Critical evaluation of external quality assessment programs remains limited despite their scope, speed and breadth of implementation. Recent publications, however, suggest that external quality assessment efforts may have major unintended consequences. These include effects on patient decision-making, the 'dynamic equilibrium' of patient care, healthcare disparities, medical innovation and practice patterns. SUMMARY: In their early years of implementation, external quality assessment programs have already had significant consequences in the healthcare system. As new tools become available, their full impact on care and caregivers must be thoroughly evaluated. Careful consideration of clinical practice implications and an understanding of the risks are critical before accepting and implementing new assessment paradigms. The substantial and widespread effects of these programs should prompt further evaluation from the medical community.
机译：审查目的：绩效付费，成绩单和国家排名等形式的外部质量评估计划正在迅速超越传统的内部质量评估工作和外部临床实践指南。尽管此类举措旨在通过促进竞争和提高透明度来提高医疗质量，但对其有效性和意想不到的效果的审查才刚刚成为全国关注的焦点。最近的发现：尽管外部质量评估计划的范围，速度和实施范围很广，但对其的严格评估仍然很有限。但是，最近的出版物表明，外部质量评估工作可能会产生重大的意想不到的后果。这些包括对患者决策的影响，患者护理的“动态平衡”，医疗保健差距，医疗创新和实践模式。摘要：在实施初期，外部质量评估计划已经对医疗保健系统产生了重大影响。随着新工具的出现，必须彻底评估它们对护理人员的全面影响。在接受和实施新的评估范式之前，认真考虑临床实践的含义和了解风险至关重要。这些计划的实质性和广泛影响应促使医学界进一步评估。

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