关于严重疾病沟通系统级改进的教训:在五个卫生系统中对严重疾病护理计划实施的定性研究
Joint Commission journal on quality and patient safety
|August 3, 2023
概括
实施严重疾病护理计划 (SICP) 需要可见的领导支持,强大的电子健康记录 (EHR) 基础设施和持续的临床医生培训. 这些元素对于改善严重疾病对话和患者的治疗结果至关重要.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 医学沟通策略 医疗沟通策略
- 医疗保健服务研究 医疗服务研究
背景情况:
- 严重疾病的沟通对于高质量的护理至关重要,但很难实现.
- 严重疾病护理计划 (SICP) 旨在改善严重疾病对话和患者的治疗结果.
- 本研究探讨了影响SICP现实世界的有效性的组织和实施因素.
研究的目的:
- 检查影响严重疾病护理计划 (SICP) 成功的组织和实施因素.
- 在医疗保健机构中识别严重疾病传播倡议的促进者和抑制者.
主要方法:
- 涉及半结构面试的定性研究.
- 在采用SICP的五个卫生系统中采访了30名卫生专业人员.
- 研究了影响SICP改进的组织和实施因素.
主要成果:
- 超过4,600名临床医生接受了培训,56,000多名患者参与了EHR记录的严重疾病对话.
- 关键促进者:可见的领导支持,强大的电子健康记录/数据基础设施,持续的临床医生培训/支持.
- 抑制因素:领导的不作为,竞争的优先事项,可变的技术采用,以及培训后的支持不足.
结论:
- 成功实施SICP需要多层次的组织策略来优先考虑,奖励和加强严重疾病沟通.
- 结果为实施SICP和类似的质量改进计划提供了组织路线图.
- 持续的承诺和综合系统对于有效的严重疾病沟通至关重要.
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