通过在重症监护室实施一套核心质量指标减轻行政负担:一项多中心纵向干预研究。

IF 5.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Gijs Hesselink, Rutger Verhage, Brigitte Westerhof, Eva Verweij, Malaika Fuchs, Inge Janssen, Catrien van der Meer, Iwan C C van der Horst, Paul de Jong, Johannes G van der Hoeven, Marieke Zegers
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引用次数: 0

摘要

背景:临床医生需要记录数据的质量指标越来越多。许多指标的有效性令人担忧。本研究旨在确定在重症监护室(ICU)中仅使用一套基于共识的核心质量指标是否会减少重症监护室专业人员记录绩效数据所花费的时间和行政负担,以及这是否会在不影响重症监护室护理质量的情况下带来更多工作乐趣:方法:2021 年 5 月至 2023 年 6 月期间,荷兰七家医院的重症监护室临床医生被要求只记录一组核心质量指标的数据。在三个时间点,通过有效问卷调查收集用于记录的时间、管理负担和工作乐趣。有关标准化死亡率(SMR)和重症监护病房再入院率的纵向数据则来自荷兰国家重症监护登记处。对重症监护室之间以及护士和医生之间的纵向影响和结果差异进行了统计学检验:在 T0、T1 和 T2 阶段,分别有 390 份(60%)、291 份(47%)和 236 份(40%)问卷被回收。在 T2 阶段,每天花在文件记录上的总时间中位数减少了 30 分钟(p 结论:实施一套核心质量指标可减少重症监护室临床医生花在文件记录和行政管理上的时间,同时不会对 SMR 或重症监护室再入院率产生负面影响。节省下来的时间可以投入到患者护理工作中,提高重症监护室的工作乐趣。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reducing administrative burden by implementing a core set of quality indicators in the ICU: a multicentre longitudinal intervention study.

Background: The number of quality indicators for which clinicians need to record data is increasing. For many indicators, there are concerns about their efficacy. This study aimed to determine whether working with only a consensus-based core set of quality indicators in the intensive care unit (ICU) reduces the time spent on documenting performance data and administrative burden of ICU professionals, and if this is associated with more joy in work without impacting the quality of ICU care.

Methods: Between May 2021 and June 2023, ICU clinicians of seven hospitals in the Netherlands were instructed to only document data for a core set of quality indicators. Time spent on documentation, administrative burden and joy in work were collected at three time points with validated questionnaires. Longitudinal data on standardised mortality rates (SMR) and ICU readmission rates were gathered from the Dutch National Intensive Care registry. Longitudinal effects and differences in outcomes between ICUs and between nurses and physicians were statistically tested.

Results: A total of 390 (60%), 291 (47%) and 236 (40%) questionnaires returned at T0, T1 and T2. At T2, the overall median time spent on documentation per day was halved by 30 min (p<0.01) and respondents reported fewer unnecessary and unreasonable administrative tasks (p<0.01). Almost one-third still experienced unnecessary administrative tasks. No significant changes over time were found in joy in work, SMR and ICU readmission.

Conclusions: Implementing a core set of quality indicators reduces the time ICU clinicians spend on documentation and administrative burden without negatively affecting SMR or ICU readmission rates. Time savings can be invested in patient care and improving joy in work in the ICU.

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来源期刊
BMJ Quality & Safety
BMJ Quality & Safety HEALTH CARE SCIENCES & SERVICES-
CiteScore
9.80
自引率
7.40%
发文量
104
审稿时长
4-8 weeks
期刊介绍: BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement. The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.
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