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首页> 外文期刊>Academic Medicine: Journal of the Association of American Medical Colleges >Engaging residents and fellows to improve institution-wide quality: The first six years of a novel financial incentive program
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Engaging residents and fellows to improve institution-wide quality: The first six years of a novel financial incentive program

机译：吸引居民和研究人员提高机构范围的质量：新颖的经济激励计划的头六年

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摘要

PURPOSE: Teaching hospitals strive to engage physicians in quality improvement (QI), and graduate medical education (GME) programs must promote trainee competence in systems-based practice (SBP). The authors developed a QI incentive program that engages residents and fellows, providing them with financial incentives to improve quality while simultaneously gaining SBP experience. In this study, they describe and evaluate success in meeting goals set during the program's first six years. METHOD: During fiscal years (FYs) 2007-2012, QI project goals for all or specific training programs were set collaboratively with residents and fellows at the University of California, San Francisco (UCSF). Data were collected from administrative databases, via chart abstraction, or through independently designed techniques. RESULTS: Approximately 5,275 residents and fellows were eligible and participated in the program. A total of 55 projects were completed. Among the 18 all-program projects, goals were achieved for 11 (61%) in three domains: patient satisfaction, quality/safety, and operation/utilization. Among the 37 program-specific projects, goals were achieved for 28 (76%) in four categories: patient-level interventions, enhanced communication, workflow improvements, and effective documentation. Residents and fellows earned an average of $800 in bonuses/FY for achieving these goals. CONCLUSIONS: Thousands of residents and fellows across disciplines participated in real-life, real-time QI during the program's first six years. Participation provided an experience that may promote SBP competence and resulted in improved quality of care across the UCSF Medical Center. Similar programs may assist teaching hospitals and GME programs in meeting current and future QI and training mandates.
机译：目的：教学医院努力使医生参与质量改进（QI），而研究生医学教育（GME）计划必须提高受训者在基于系统的实践（SBP）中的能力。作者开发了一个QI激励计划，吸引了居民和同伴，为他们提供了经济激励，以提高他们的素质，同时获得SBP的经验。在这项研究中，他们描述并评估了在实现计划最初六年中设定的目标方面所取得的成功。方法：在2007-2012财政年度（FYs）中，与加利福尼亚大学旧金山分校（UCSF）的居民和研究员共同制定了所有或特定培训计划的QI项目目标。通过图表抽象或通过独立设计的技术从管理数据库中收集数据。结果：大约有5,275名居民和研究员符合资格并参加了该计划。共完成55个项目。在18个全计划项目中，在以下三个方面实现了11个目标（61％）的目标：患者满意度，质量/安全性和操作/使用率。在37个针对特定项目的项目中，在以下四个类别中实现了28个（76％）的目标：患者水平的干预，增强的沟通，工作流程的改进和有效的文档编制。为实现这些目标，居民和同伴/财政年度平均获得800美元的奖金。结论：在该计划的头六年中，成千上万的跨学科的居民和研究人员参加了实时的实时QI。参与提供的经验可能会提高SBP能力，并导致整个UCSF医疗中心的医疗质量得到改善。类似的计划可以帮助教学医院和GME计划满足当前和将来的QI和培训要求。

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