A Department of Medicine Infrastructure for Patient Safety and Clinical Quality Improvement

作者：Mathews Simon C.; Pronovost Peter J.; Biddison E. Lee Daugherty; Petty Brent G.; Anderson Mark E.; Nelson Terry S.; Outten Katie; Langlotz Ronald; Duda Denice; Herzke Carrie A.; Peairs Kimberly S.; Golden Sherita H.; Lautzenheiser Matthew B.; James Hailey J.; Desai Sanjay V.; Keller Sara C.; Feldman Leonard S.; Pahwa Amit K.; Berry Stephen A.^*

来源：American Journal of Medical Quality, 2018, 33(4): 413-419.

DOI：10.1177/1062860617743324

• quality and safety
• quality management system
• governance
• accountability

Payers, providers, and patients increasingly recognize the importance of quality and safety in health care. Academic Departments of Medicine can advance quality and safety given the large populations they serve and the broad spectrum of diseases they treat. However, there are only few detailed examples of how quality and safety can be organized. This article describes a practical model at The Johns Hopkins Hospital Department of Medicine and details its structure and operation within a large academic health system. It is based on a fractal model that integrates multiple smaller units similar in structure (composition of faculty/staff), process (use of similar tools), and approach (using a common framework to address issues). This organization stresses local, multidisciplinary leadership, facilitates horizontal connections for peer learning, and maintains vertical connections for broader accountability.

• 出版日期2018-8