美国外科医生学会创伤质量改善计划(TQIP)为创伤中心提供了有关其相对于同龄人的护理过程和结果的绩效报告。这项研究探讨了创伤中心领导者如何使用绩效报告来提高绩效和感知使用障碍。
美国创伤中心创伤医疗主管(TMD)和创伤计划经理(TPM)的定性焦点小组研究。与定性描述性分析一致,数据收集和解释是归纳和迭代完成的。主要主题是使用恒定的比较技术得出的。
进行了六个焦点小组,涉及22个TMD和22个TPM。捕获了三个主要主题:(1)绩效报告的技术用途;(2)绩效报告的文化用途;(3)增强TQIP作用和价值的机会。首先,技术用途包括使用报告评估数据收集程序,数据质量和相对于同行表现不佳的领域。在这个领域,报告使用的障碍包括不信任他人的数据质量和报告解释方面的挑战。第二,报告被用来通过促进专业间的讨论来影响实践的变化,利用资源进行质量改进,社区参与和区域合作。认为缺乏专家参与被视为该领域的障碍。最后,确定的TQIP支持报告使用的机会涉及澄清验证和性能报告之间的关系,并增加与护理协会的伙伴关系。
创伤中心改善领导者指出了绩效报告的实际和社会用途,这些用途可能会影响改变的意图和能力。优化计划参与的建议包括关注数据质量,充足的资源提供和加强对区域合作的支持。
The American College of Surgeons\' Trauma Quality Improvement Program (TQIP) provides trauma centres with performance
reports on their processes and outcomes of care relative to their peers. This study explored how performance
reports are used by trauma centre leaders to engage in performance improvement and perceived barriers to use.
Qualitative focus group study with trauma medical directors (TMDs) and trauma programme managers (TPMs) in US trauma centres. Consistent with qualitative descriptive analysis, data collection and interpretation were inductively and iteratively completed. Major themes were derived using a constant comparative technique.
Six focus groups were conducted involving 22 TMDs and 22 TPMs. Three major themes were captured: (1) technical uses of performance reports; (2) cultural uses of performance
reports; (3) opportunities to enhance the role and value of TQIP. First, technical uses included using
reports to assess data collection procedures, data quality and areas of poor performance relative to peers. In this domain, barriers to report use included not trusting others\' data quality and challenges with report interpretation. Second, reports were used to influence practice change by fostering inter-specialty discussions, leveraging resources for quality improvement, community engagement and regional collaboratives. Perceived lack of specialist engagement was viewed as an impediment in this domain. Lastly, identified opportunities for TQIP to support report use involved clarifying the relationship between verification and performance reports, and increasing partnerships with nursing associations.
Trauma centre improvement leaders indicated practical and social uses of performance
reports that can affect intention and ability to change. Recommendations to optimise programme participation include a focus on data quality, adequate resource provision and enhanced support for regional collaboratives.