从系统治疗转向系统方法美国医疗保健可持续发展之路

N. Whitehead, W. Scherer
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引用次数: 2

摘要

1999年,美国研究生医学教育认证委员会(ACGME)针对美国医疗保健系统的安全问题、低绩效和高支出率,发布了针对二年级住院医师的核心能力课程。以系统为基础的实践——第六个核心能力——是专门为提供最佳医疗保健的既定目标,将系统思维引入专业医学实践而设计的。本文将一种称为系统思维维度(DST)的系统分析技术应用于基于系统的实践。出版十三年后,基于系统的实践未能对医疗保健系统产生预期的效果,原因是目标和系统边界定义不当,缺乏定义的指标和评估程序,以及引入系统的系统性质。我们对第六个核心竞争力的改进提出建议,这将是美国医疗保健系统实现可持续性的更大努力的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Moving from systematic treatment to a systemic approach A path for sustainable U.S. healthcare
In 1999, the Core Competencies, a curriculum for second-year medical residents was published by The Accreditation Council for Graduate Medical Education (ACGME) in response to safety problems, poor performance and a high rate of expenditure in the U.S. healthcare system. Systems-based Practice - the sixth core competency - was designed specifically to bring systems thinking to the practice of specialized medicine with the stated goal of providing optimal healthcare. This paper applies a systemic analysis technique called The Dimensions of Systems Thinking (DST) to Systems-based Practice. Thirteen years after publication, Systems-based Practice has failed to have the desired effect on the healthcare system due to improperly defined objectives & system boundaries, lack of defined metrics & assessment procedures and the systematic nature of the system into which it was introduced. We make recommendations for improvements to the sixth core competency that would be part of a larger effort to achieve sustainability in the U.S. healthcare system.
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