10 the importance of audit to monitor applications of procedures and imrove primary angioplasty...
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Стратегии управления проектом SFL Важность аудита для мониторирования процесса применения процедур и улучшения результатов первичной ангиопластики Peter F. Ludman 1 *, MA, MD, FRCP, FESC; Mark A. de Belder 2 , MA, MD, FRCP; James M. McLenachan 3 , MD, FRCP; John S. Birkhead 4 , MA, MB, FRCP; David Cunningham 5 , BSc, PhD; Huon H. Gray 6 , MD, FRCP, FESC, FACC 1. Отдел аудита, Британское общество интервенционных кардиологов и Госпиталь королевы Елизаветы, г. Бирмингем, Великобритания (Audit Lead, British Cardiovascular Intervention Society (BCIS) and Queen Elizabeth Hospital, Birmingham, United Kingdom); 2. Группа мониторинга данных Национального проекта по проведению ангиопластики при инфаркте миокарда (NIAP) и госпиталь при университете Джеймса Кука, г.Мидлсбро, Великобритания (National Infarct Angioplasty Project (NIAP) Data Monitoring Group and The James Cook University Hospital, Middlesbrough, United Kingdom); 3. Программа совершенствования национальной системы здравоохранения Великобритании и Общий госпиталь г. Лидс, г. Лидс, Великобритания (NHS Improvement Programme, United Kingdom and Leeds General Infirmary, Leeds, United Kingdom); 4. Национальный проект аудита ишемии миокарда (MINAP), Национальный институт изучения клинических исходов, Университетский колледж, Лондон, Великобритания (Myocardial Ischaemia National Audit Project (MINAP), National Institute for Clinical Outcomes Research, University College, London, United Kingdom); 5. Центральная база данных аудита вмешательств на сердце, Национальный институт изучения клинических исходов, Университетский колледж, Лондон, Великобритания ( Central Cardiac Audit Database, National Institute for Clinical Outcomes Research, University College, London, United Kingdom); 6. Сопредседатель Национального проекта по проведению ангиопластики при инфаркте миокарда (NIAP) и госпиталь при Университете г. Саутгемптона, филиал Национальной службы здравоохранения, г. Саутгемптон, Великобритания ( Co-Chair, National Infarct Angioplasty Project (NIAP) and University Hospital of Southampton NHS Foundation Trust, Southampton, United Kingdom) *Автор для переписки: Отделение кардиологии, Госпиталь королевы Елизаветы, г. Бирмингем, Великобритания (Cardiology Department, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, United Kingdom). E-mail: [email protected] Резюме Несмотря на то, что в клинических исследованиях продемонстрировано, что первичные чрескожные коронарные вмешательства (пЧКВ) обеспечивают лучшие исходы при ИМСПST, чем тромболитическая терапия, невозможно ожидать, что похожие результаты могут быть получены в ежедневной практике. Чтобы определить, выполняются ли требования стандартов, необходим непрерывный аудит программ пЧКВ с надлежащей обратной связью с участвующими центрами и специалистами. Оба национальных аудиторских проекта, MINAP - Национальный проект аудита ишемии (ранее инфаркта) миокарда (Myocardial Ischaemia (formally infarction) National Audit Project) и проект Британского общества интервенционных кардиологов (БОИК), позволяют совершать электронный сбор данных о пациентах, последовательно поступающих в каждый стационар, вовлеченный в оказание экстренной помощи. Обеспечивается регулярная программируемая обратная связь с центрами, проводящими первичное ЧКВ, что позволяет совершить попытку оценки статистических вариаций и различий характеристик пациентов, поступающих в разные центры, путем использования воронкообразных графиков, графиков контроля статистического процесса и моделей выравнивания риска. Такое представление данных о процессе и результатах, как конфиденциальное, так и в открытых источниках, используется для совершенствования качества оказания помощи и ассоциируется с постоянным улучшением результатов и снижением дисбаланса в качестве оказанной помощи. Введение
Transcript of 10 the importance of audit to monitor applications of procedures and imrove primary angioplasty...
- 1. SFL Peter F. Ludman1*, MA, MD, FRCP, FESC; Mark A. de Belder2, MA, MD, FRCP; James M. McLenachan3, MD,FRCP; John S. Birkhead4, MA, MB, FRCP; David Cunningham5, BSc, PhD; Huon H. Gray6, MD, FRCP, FESC,FACC1. , , . , (Audit Lead, British Cardiovascular Intervention Society (BCIS) and Queen Elizabeth Hospital, Birmingham, UnitedKingdom);2. (NIAP) , ., (National Infarct Angioplasty Project (NIAP) DataMonitoring Group and The James Cook University Hospital, Middlesbrough, United Kingdom);3. . , ., (NHS Improvement Programme, United Kingdom and Leeds General Infirmary, Leeds, United Kingdom);4. (MINAP), , , , (Myocardial Ischaemia National Audit Project (MINAP), National Institute forClinical Outcomes Research, University College, London, United Kingdom);5. , , , , ( Central Cardiac Audit Database, National Institute for Clinical OutcomesResearch, University College, London, United Kingdom);6. (NIAP) . , , . , ( Co-Chair,National Infarct Angioplasty Project (NIAP) and University Hospital of Southampton NHS Foundation Trust, Southampton, UnitedKingdom)* : , , . , (Cardiology Department, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH,United Kingdom). E-mail: [email protected] , , () ST, , , . , , . , MINAP - () (Myocardial Ischaemia (formally infarction) National Audit Project) (), , , . , , , , , . , , , .
2. , , () ST, (1), , , . , , , - , - . , . , , . , . , . . , , , , . , . . - , 1988 . () (British Cardiovascular InterventionSociety). . - , 1996 . () (Central Cardiac AuditDatabase), . ( (National Service Framework for Coronary Heart Disease)) (2), ( ) (MINAP) (Myocardial Infarction (now Ischaemia) National Audit Project). 1999 ., MINAP , . , . , MINAP ST, , (3). , , , (4). -, () , . () (National Institute for Clinical Outcomes Research), , , (. 1) (5). ( ) 2005 . , ( ), - , , . , Lotus Notes, -. 3. . ( ). , . , , , , . , , : , -, , , .. - 113 , ( ), . - . , . , , , . , MINAP , , . 1. , () (Central Cardiac Audit Database (CCAD)), () (National Institute for Cardiovascular Outcomes Research (NICOR)). , , 4. , . , 12 (. 2). , (. ). , 100% . , , , , (. 3). . (6), . 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