应用i-PARIHS来识别医院出院决策中的新兴创新,以应对系统压力:一项定性研究
Allison M Gustavson1, Matthew J Miller2, Natassia Boening1
1Minneapolis Veterans Affairs Health Care System.
Research square
|August 30, 2023
概括
康复临床医生在COVID-19期间通过调整沟通和护理交付,创新了出院流程. 结果突出了影响这些关键医疗保健创新的系统,团队和患者因素.
科学领域:
- 医疗保健提供创新 医疗保健提供创新
- 康复医学是康复的医学.
- 卫生系统研究 卫生系统研究
背景情况:
- 在COVID-19大流行期间使用学习健康系统方法研究影响康复出院决策创新的因素.
- 专注于了解临床医生如何适应医院出院过程中前所未有的挑战.
研究的目的:
- 确定影响康复医院出院决策的创新因素.
- 在COVID-19大流行期间应用学习健康系统方法.
主要方法:
- 使用与康复临床医生 (物理和职业治疗师) 进行半结构面试的定性研究.
- 采用了整合的促进卫生服务研究实施行动 (i-PARIHS) 框架.
- 使用快速定性,演性的基于团队的分析与有针对性的内容分析.
主要成果:
- 由于患者/家庭对家庭出院的偏好,在沟通 (从面对面到虚拟) 和目标设定方面出现了创新.
- 医院系统,跨学科动态和政策变化影响了临床医师的创新.
- 新兴的创新包括加强团队协作,案件负载优先级转移,以及急性后替代性护理选择.
结论:
- 康复临床医生通过开发创新策略来应对大流行期间系统层面的变化,表现出显著的适应能力.
- 进一步的研究对于评估这些创新对未来医疗保健需求的影响和实施至关重要.
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