Quality Improvement Program for Primary Care Clinics

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K08547
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Hamamatsu University School of Medicine (2015, 2017-2018); Teikyo University (2016)
• Principal Investigator: Inoue Machiko 浜松医科大学, 医学部, 特任教授 (80609090)
• Research Collaborator: Wee Christina ; Taylor William
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 医療の質 / プライマリ・ケア / 患者経験 / 質向上 / 質向上プログラム

Outline of Final Research Achievements

Prior to this study, the Japanese version of Primary Care Assessment Tool had been developed and used for quality assessment and research in terms of patient experiences of primary care in Japan. I conducted a review of literature regarding the Patient-Centered Medical Home initiative in the U.S., and also conducted the field survey at one of them in the U.S. The education for quality improvement and patient safety at that setting was researched. Utilization of clinical data, assessment through patient experiences, and population health management were the key areas in those activities.
Next, based on the research, a pilot workshop was conducted for the staff of three Japanese primary care clinics. Basic knowledge on healthcare quality and patient safety was reviewed. The staff considered the correct patient identification, less waiting time for patients at the clinic, and the clinical data management were the important issues.

Free Research Field

プライマリ・ケア

Academic Significance and Societal Importance of the Research Achievements

病院と異なり、診療所で提供する医療の質については、評価、改善のしくみが整備されていない。かかりつけの診療所における医療の質について、患者が自身の体験に基づいて評価する指標を開発している（患者中心のプライマリ・ケア質評価　http://www.primary-care-quality.com）。
診療所医師・スタッフがこれを用いて、質向上に取り組むことができるよう、その活動や教育のあり方について、米国での実情を調査した。患者経験調査に加え、診療データの有効活用や、地域住民全体の健康向上を目指した取り組みが評価されていた。それをふまえ、３カ所の診療所で教育ワークショップのパイロット実施を行った。