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改善重症患者的护理:机构和医疗保健系统的方法
1Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) Laboratory, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. angusdc@ccm.upmc.edu
Lancet (London, England)
|April 20, 2004
概括
改善重症监护需要采用多方面的方法,将机构策略与病床护理结合起来. 建议结合教育,指导方针,绩效报告,激励和系统重组,以获得持续的影响.
科学领域:
- 临界护理医学 临界护理医学
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
背景情况:
- 临界护理服务面临着需求增长和成本压力带来的挑战.
- 仅靠床边策略就不足以为重症患者提供最佳护理.
- 机构和医疗保健系统的方法是指导患者护理的关键补充.
研究的目的:
- 审查机构和医疗保健系统的战略,以改善重症监护.
- 确定有效的方法,以提高美国和英国的重症患者的护理.
- 推一项全面的战略,以优化重症监护的提供.
主要方法:
- 针对美国和英国的七种机构和系统层面的方法进行了重点审查.
- 教育的分析,组织指导方针,绩效报告,激励,监管,法律要求和系统重组.
- 考虑当前的举措和未来的方向,以改善重症监护.
主要成果:
- 没有单一的方法能保证持续的改进;需要一种组合.
- 与金融激励相关的绩效报告显示出有希望的结果.
- 建议公众教育和组织指导方针 (例如,ICU录取标准,人员配置).
- 基本服务的重组,包括区域化护理和医生扩展器的使用,是必不可少的.
结论:
- 为了持续改善重症监护,需要采取多项机构和系统级干预措施的综合战略.
- 建议继续开发绩效报告,公众教育和组织指南.
- 医疗保健服务的根本性重组,包括区域化和扩大先进从业人员的使用,对于最佳的重症护理提供至关重要.
相关概念视频
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For example, a patient with a chronic illness...
For example, a patient with a chronic illness...