开展优质护理服务转变临床护理模式

为进一步落实卫计委关于优质护理服务示范工程相关文件精神，更好的推进优质护理服务工作，我院开始探索转变临床护理模式，加强临床护理工作，促进护理工作贴近患者、贴近临床、贴近社会，为患者提供优质、高效、连续的护理服务。     

优质护理服务实施模式探讨

目的：探讨优质护理服务实施模式。方法：对全院病区实施优质护理服务的方法进行总结,比较分析实施优质护理服务前后效果。结果：护理投诉纠纷明显减少,基础护理质量、患者满意度显著提高,差异有统计学意义（P〈0．05）。结论：按照实行责任制护理、分层次使用护士、落实基础护理、完善护理质量检查管理体制等模式开展优质护理服务有利于护患沟通,有利于落实基础护理,提高了患者满意度,降低了护理风险,值得推广乙     

践行优质护理 提升护理服务质量

结合神经外科ICU实施优质护理的实践,从建立健全规章制度并严格执行;强化培训,积极转变观念;落实护士分层管理;简化护理文书书写;落实基础护理,强化细节服务;明确标识,落实差错管理等6方面,总结了优质护理的主要经验。     

护士人力资源及绩效管理在优质护理服务的实践

目的:落实优质护理服务,探索科学的护理人力资源及护理绩效管理方式。方法:结合我院护理工作任务、内容、程序、人力和时间等影响因素,采取"护士层级搭班排班"进行护士人力资源管理。结果:达到合理使用护士人力资源,体现优质护理服务的护士分层级使用、落实岗位责任制等工作内涵,体现优质护理服务多劳多得、优劳优酬的绩效激励机制。结论:在实施责任制整体护理工作模式、落实岗位管理加强护士落实责任制护理的同时,建立绩效管理等长效管理机制及激励机制,无疑是促进优质护理服务有效、良性、深入发展的有效举措。     

爱婴病房开展优质护理服务后的效果分析

目的 对爱婴病房开展优质护理服务后的效果进行分析.方法 将2012年1月～11月我院产科住院阴道分娩的初产妇607例对母婴落实优质护理服务-效果与实行优质护理服务前2011年1月～12月住院阴道分娩的初产妇600对母婴护理效果相比较,采用回顾性分析的方法对比实施优质护理前后产妇正确哺乳、挤奶、新生儿沐浴的人数等.结果 落实优质护理服务后产妇正确哺乳、挤奶、新生儿沐浴、出院后1个月母乳喂养人数均高于落实优质护理服务前、出生后1个月内发生乳头皲裂、乳腺炎、新生儿脐炎、红臀的人数均低于落实优质护理服务前,差异有统计学意义（p＜0.05）.结论 优质护理-母婴床旁护理模式提高了产妇正确哺乳、挤奶、新生儿沐浴、出生后1个月母乳喂养率,降低了出生后1个月内乳头皲裂、乳腺炎、新生儿脐炎、红臀的发生率,让产妇享受了人性化、系统化、规范化的护理服务,产妇及家属更好的掌握了母婴保健知识与技能,保障了母婴安全.     

医疗联合体下的护理同质化管理

医疗卫生联合体,是医疗资源纵向整合的一种实现形式,旨在通过改革,竭力为群众提供全程、连续、优质、便捷、经济的医疗卫生服务。作为全国优质护理服务重点联系医院,贵州省人民医院把开展优质护理服务的宝贵经验直接传授给各分院,帮助建立优质护理服务病房,改革工作模式,落实分级护理职责,为病人提供全面、全程、专业、人性化的护理服务。     

优质护理服务在产科病房的实践

2010年卫生部提出“夯实基础护理,提供满意服务”,实施优质护理示范工程,全面提高护理服务质量和患者满意度,笔者所在医院产科作为试点科室,通过加强相关配置,改善护理服务,夯实基础护理,达到提升患者满意度、构建和谐医患关系的目的。严格执行各项护理制度,落实基础护理,开展特色服务,取得了满意的成效,提高了护理满意度。实施优质护理示范工程,充分调动护理人员的主观能动性,保证各项优质护理服务措施落实,达到了患者满意、社会满意、政府满意的效果。     

消毒供应中心落实优质护理服务的实践

目的探究消毒供应中心落实优质护理服务的实践效果。方法我院2015年在消毒供应中心实施优质护理服务,2014年未实施优质护理服务,比较实施前后的护理效果。结果实施优质护理服务后的护理工作质量与科室满意度评分均明显高于实施优质护理服务前,比较组间数据差异显著,P<0.05。结论对消毒供应中心全面落实优质护理服务的应用效果显著,可明显提高护理服务工作质量,值得实践推广。     

创优护理服务品质 促进护理专业发展

通过开展"优质护理服务示范工程"活动,改革护理模式,优化责任分工方式,加强科学管理,确保护理职责落实,使人民群众切实享受到医改所带来的实惠。推广优质护理服务,不断提升患者满意度,形成长效机制,促进护理专业发展。     

医疗联合体下的护理同质化管理

<正>医疗卫生联合体,是医疗资源纵向整合的一种实现形式,旨在通过改革,竭力为群众提供全程、连续、优质、便捷、经济的医疗卫生服务。作为全国优质护理服务重点联系医院,贵州省人民医院把开展优质护理服务的宝贵经验直接传授给各分院,帮助建立优质护理服务病房,改革工作模式,落实分级护理职责,为病人提供全面、全程、专业、人性化的护理服务。同时,派驻护理专家充分发挥学术引领作     

健康医疗大数据质量治理研究

健康医疗大数据质量治理对促进医疗大数据产出具有重要的研究价值。通过分析健康医疗大数据特点,指出医疗大数据存在的质量问题,提出质量治理的对策建议,包括全面加强质量管理组织机构与人才队伍建设,加快数据质量标准体系建设,积极推动数据质量管理工具等关键技术的发展,落实医疗机构内部数据质量安全管理规范等。     

医疗质量长效机制的探讨

通过加强对医务人员的培训,建立医疗质量监控和规章制度执行的跟踪问效问责制度,加强医德医风建设和医院文化建设等,探索建立医疗质量的长效机制。提出了提高人员技能素质、落实规章制度、增强工作责任心分别是提高医疗质量的根本、关键和保证的观点。     

推进优质护理 提升护理质量——特邀策划顾问

护理改革是公立医院改革的一个缩影,是评价公立医院改革成功与否的重要标尺。自2010年初卫生部推行“优质护理服务示范工程”活动以来,护理服务质量有了显著提高。开展优质护理不仅是提升护理服务的良好契机,更是解决制约护理服务改进的管理机制、激励机制等方面问题的重大突破。通过开展优质护理,改革护理工作模式,全面落实责任制整体护理;加强服务内涵建设,改善患者服务体验;     

A Quality of Care Framework for Home-Based Medical Care

More than 6 million adults in the United States are homebound or semi-homebound and would benefit from home-based medical care (HBMC). There is currently no nationally recognized quality of care framework for home-based medical care. We sought to capture diverse stakeholder perspectives on the essential aspects of quality HBMC and create a quality of care framework for homebound adults. A qualitative analysis of semistructured interviews from purposive sampling of key HBMC stakeholders was performed. Leaders from 12 exemplar HBMC practices (clinicians and administrators), advocacy groups (American Association of Retired Persons, National Partnership for Women and Families, Kaiser Family Foundation), and representatives from 3 key professional medical societies associated with HBMC participated in phone interviews. Semistructured interviews were based on domains of quality developed by the National Quality Forum (NQF) for individuals with multiple chronic conditions. We identified 3 categories of quality HBMC: provider and practice activities; provider characteristics; and outcomes for patients, caregivers, and providers. Within these 3 categories, we identified 10 domains and 49 standards for quality HBMC. These included 3 new domains (comprehensive assessment, patient/caregiver education, and provider competency) as well as specification and adaptation of the NQF Framework for Multiple Chronic Conditions domains for HBMC. Notably, several quality domains emanating from the NQF Framework for Multiple Chronic Conditions (transitions, access, and patient/caregiver engagement) were applicable to HBMC. This quality of care framework serves as a guide for HBMC practices seeking to improve their care quality and as a starting point for health systems and payers to ensure value from HBMC practices with whom they work.     

Quality Clinical Care in Nursing Facilities

Despite improvements in selected nursing facility (NF) quality measures such as reduction in antipsychotic use; local, state, and national initiatives; and regulatory incentives, the quality of clinical care delivered in this setting remains inconsistent. Herein, recommendations for overcoming barriers to achieving consistent, high-quality clinical outcomes in long-term (LTC) and post-acute care are provided to address inadequate workforce, suboptimal culture and interprofessional teamwork, insufficiently evidence-based processes of care, and poor adoption and fidelity of technology and integrated clinical decision support. With high staff attrition rates in NFs, mechanisms to measure and close knowledge gaps as well as opportunities for practice simulations should be available to educate and ensure adoption of clinical quality standards on clinician hiring and on an ongoing basis. Multipronged, integrated approaches are needed to further the quest for sustainment of high clinical quality in NF care. In addition to setting a tone for attainment of clinical quality, leadership should champion adoption of practice standards, quality initiatives, and evidence-based guidelines. Maintaining an optimal ratio of hours per resident per day of nurses and nurse aides can improve quality outcomes and staff satisfaction. Clinicians must consistently and effectively apply care processes that include recognition, problem definition, diagnosis, goal identification, intervention, and monitoring resident progress. In order to do so they must have rapid, easy access to necessary tools, including evidence-based standards, algorithms, and care plans, during the care delivery process. Embedding such tools into workflow of electronic health records has the potential to improve quality outcomes. On a national and international level, quality standards should be developed by interprofessional LTC experts committed to applying the highest levels of clinical evidence to improve the care of older persons. The standards should be realistic and practical, and basic principles of implementation science must be used to achieve the desired outcomes.     

提高病案首页数据采集质量

病案首页是医院质量管理的重要原始资料。对影响病案首页数据采集质量的因素从人员与管理两方面进行了分析,指出通过加强培训,提高医务人员数据采集质量意识;依托病案全程动态质量监控网络,加强数据源管理;调动医务人员参与信息管理的积极性等措施,可有效提高病案首页数据采集质量。     

Is There Any Ideal of ‘High Quality Care’ Opposing ‘Low Quality Care’? A Deconstructionist Reading

The expressions ‘high quality care’ and ‘low quality care’ are cognitive and linguistic artefacts that help to structure people’s lives and thinking; for example, moves are now afoot internationally to pay bonuses to health professionals for delivering high quality care. United States programmes, most conspicuously, are assuming that high quality care can be validly distinguished from low quality care, and incentivised through bonuses. This distinction is always at least implicit, for high quality care has no meaning without low quality care. Through a ‘deconstructionist reading,’ this article discusses limitations of categorising the quality of care as either high or low. The limitations of this ‘binary opposition’ can include a lack of defining attributes; vagueness and fuzziness at the ‘boundaries’ between high quality care and low quality care; concealment of quality as a continuum; and use of the binary opposition to effect social order and control. Health policy implications of our analysis are discussed. Drawing upon the general medical services contract in the United Kingdom, we suggest an approach to overcoming the oversimplification and imprecision that categorisation tends to produce.     

Assessing Diabetes Care Disparities with Ambulatory Care Quality Measures

ObjectiveTo identify and describe racial/ethnic disparities in overall diabetes management.ConclusionsAlthough this health system has above-average diabetes care quality, significant disparities by race/ethnicity were identified. This underscores the importance of stratifying quality measures to improve care and outcomes for all.     

Ipro's Health Care Quality Improvement Program

IPRO is a peer-review organization in New York State that functions under a contract with the Health Care Financing Administration (HCFA) of the U.S. Department of Health and Human Services for assuring quality of care for Medicare patients. In 1993, IPRO initiated its Health Care Quality Improvement Program (HCQIP). The purpose of this program is to develop information on patterns of care and outcomes, to share this with health care providers, and in so doing effect measurable improvements in care and outcomes. In order to achieve improvements in the quality of care, IPRO has initiated a series of cooperative projects which combine pattern analysis and feedback. These cooperative projects cover a broad range of medical care issues and areas. They have demonstrated that IPRO, providers, and physicians can collaborate to establish and implement efforts to achieve the ultimate goal of improved quality of care for Medicare beneficiaries.Theodore O. Will, MPA is Executive Vice-President, IPRO.