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Mejorar la calidad de la comunicación escrita en el momento del alta del paciente: triangulación de los análisis
Ola Markiewicz1, Fabiana Lorencatto2, Danielle D'Lima2
1Department of Surgery and Cancer, Imperial College London, London, UK.
Lancet (London, England)
|November 24, 2023
Resumen
Las malas transferencias de pacientes del hospital a la atención primaria ponen en riesgo a los pacientes vulnerables. La ciencia del comportamiento identificó técnicas para mejorar la documentación de alta y la seguridad del paciente durante las transiciones.
Área de la Ciencia:
- Investigación en servicios de salud
- Ciencias del comportamiento
- Seguridad del paciente
Sus antecedentes:
- La transferencia inadecuada del hospital a la atención primaria plantea riesgos para el alta segura de los pacientes, especialmente para las personas mayores y frágiles.
- La utilización de los principios de la Ciencia del Comportamiento para comprender y mejorar los procesos de alta es crucial para la seguridad del paciente.
Objetivo del estudio:
- Explorar las influencias en la calidad de la entrega de alta escrita desde el hospital a la atención primaria.
- Identificar y aplicar técnicas de cambio de comportamiento (BCT) para mejorar la documentación de la entrega y la seguridad del paciente.
Principales métodos:
- Realizó observaciones etnográficas y entrevistas semiestructuradas con el personal del hospital involucrado en el alta de pacientes.
- Los hallazgos se asignaron teóricamente al Marco teórico de dominios (TDF) e identificaron las BCT pertinentes.
- Trabajadores de la salud comprometidos, pacientes y cuidadores en talleres para diseñar una intervención.
Principales resultados:
- Se identificaron 11 factores clave que influyen en la calidad de la entrega en cinco ámbitos de la formación profesional, incluidos los conocimientos, las habilidades, el papel, el medio ambiente y los factores sociales.
- Se seleccionaron 14 BCT, como ensayo de comportamiento, instrucción y apoyo social, para abordar las influencias identificadas.
- Desarrolló una intervención educativa multifacética a través de talleres de colaboración.
Conclusiones:
- La mejora de la calidad de la documentación de traspaso de la atención hospitalaria a la atención primaria requiere un enfoque multifacético que aborde varios factores que influyen.
- La intervención diseñada justifica pruebas clínicas con las partes interesadas de la atención primaria para evaluar su impacto en la calidad de la entrega y la seguridad del paciente.
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