Improvements in health care are slow, in part because doctors and nurses lack skills in quality improvement, patient safety, and interprofessional teamwork. This article reports on the Retooling for Quality and Safety initiative of the Josiah Macy Jr. Foundation and the Institute for Healthcare Improvement, which sought to integrate improvement and patient safety into medical and nursing school curricula. In one academic year, 2009-10, the initiative supported new learning activities (87 percent of which were interprofessional, involving both medical and nursing students) in classrooms, simulation centers, and clinical care settings that involved 1,374 student encounters at six universities. The work generated insights-described in this article-into which learning goals require interprofessional education; how to create clinically based improvement learning for all students; and how to demonstrate the effects on students' behavior, organizational practice, and benefits to patients. A commonly encountered limiting factor for the programs was the lack of a critical mass of clinically based faculty members who were ready to teach about the improvement of care. What's more, the paucity of robust evaluation strategies for such programs suggests a future research agenda that deserves to be funded.

译文

:医疗保健方面的改进缓慢,部分原因是医生和护士缺乏提高质量,患者安全和跨专业团队合作的技能。本文报道了Josiah Macy Jr. Foundation和医疗保健改善研究所的“质量与安全重组”倡议,该倡议旨在将改善和患者安全纳入医疗和护理学校课程。在2009-10学年的一个学年中,该计划支持了教室,模拟中心和临床护理环境中的新学习活动(其中87%是跨专业的,涉及医学和护理学的学生),涉及六所大学的1,374名学生。这项工作产生了本文中介绍的见解,其中的学习目标需要跨专业的教育;如何为所有学生创建基于临床的改进学习;以及如何证明对学生的行为,组织实践和对患者的好处的影响。该计划的一个普遍遇到的限制因素是缺乏足够数量的临床教师来准备教授改善护理的知识。而且,此类计划缺乏强有力的评估策略,这表明未来的研究议程值得资助。

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