确定护理的一致性和质量的时间结构:超急性中风服务的案例研究
Georgia B Black1,2, Angus I G Ramsay3, Robert Simister4
1Applied Health Research, University College London, London, UK g.black@ucl.ac.uk.
BMJ quality & safety
|June 19, 2023
概括
超急性中风病房的时间结构会影响护理质量. 提高一致性需要改变服务设计,人员配置和社会规范,特别是在周末工作方面.
科学领域:
- 医疗保健管理的管理
- 提高质量 提高质量
- 脑卒中护理 脑卒中护理
背景情况:
- 时间结构受实践和社会规范的影响,显著影响医疗保健的质量和时间.
- 对初始中风护理至关重要的超急性中风病房进行了研究,以了解时间结构对质量的影响.
研究的目的:
- 探索超急性中风病房内的时间结构模式.
- 解释这些模式如何影响中风护理的质量.
主要方法:
- 对76名超急性中风工作人员进行的定性访谈进行主题分析.
- 非参与者观察 (41次会议,约102小时) 和服务标准指导的文档分析.
- 使用诱导编码来识别与时间结构相关的主题发现.
主要成果:
- 临床优先事项和指标驱动迅速的初步干预.
- 病房组织 (rotas,病房巡回) 和社会规范 (特别是周末工作) 影响护理的一致性和质量.
- 由于时间结构造成的瓶和积压阻碍了有效的服务改进.
结论:
- 在高质量的患者护理中,时间一致性至关重要.
- 服务设计 (人员,途径) 和对工作模式的文化态度是时间一致性的关键.
- 改进需要对轮班和病房巡回等结构元素进行改变,同时应对周末工作的社会规范.
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