执行VA国家远程神经病学计划:以RE-AIM框架为指导的混合方法评估
Teresa M Damush1,2,3, Jayne R Wilkinson4,5, Holly Martin3
1Richard L. Roudebush VAMC HSR&D EXTEND QUERI, Indianapolis, IN, United States.
Frontiers in health services
|September 11, 2023
概括
退伍军人健康管理局的退伍军人健康管理局.
科学领域:
- 实施科学 实施科学
- 医疗服务研究 医疗服务研究
- 远程医疗服务是远程医疗服务.
背景情况:
- 退伍军人卫生管理局 (VHA) 国家远程神经病学计划 (NTNP) 成立,旨在解决退伍军人,特别是农村地区退伍军人门诊神经病学护理的缺口.
- 退伍军人事务 (VA) 农村卫生办公室 (ORH) 资助了NTNP作为一项全企业倡议 (EWI),以改善医疗保健服务.
- 使用RE-AIM框架进行实用评估,以评估NTNP服务.
研究的目的:
- 使用RE-AIM框架,务实地评估VHA国家远程神经病学计划 (NTNP) 的实施情况.
- 评估NTNP服务的覆盖范围,有效性,采用,实施成功和维护.
- 确定有助于高退伍军人满意度和计划感知有效性的因素.
主要方法:
- 根据RE-AIM框架的指导,使用混合方法方法进行前性实施评估.
- 这些指标包括NTNP新患者咨询量,临床接触,退伍军人满意度,转诊提供者的感知有效性,现场工作人员采访以及利益相关者评估的定性分析.
- 通过每季度的TeleNeurology咨询量来监测维护情况.
主要成果:
- 在两年内,NTNP在13个VA医疗中心成功实施,患者咨询和临床接触的数量大幅增加.
- 该计划的覆盖范围显著,超过一半的新患者居住在农村地区.
- 退伍军人报告了高度满意度,并引用了良好的沟通,减少旅行,以及获得否则无法获得的护理;推提供者认为高效率.
结论:
- 在VA NTNP成功地展示了覆盖范围,采用,有效性,实施成功和维护.
- 该计划对转诊提供者和接受护理的退伍军人来说都非常可接受.
- RE-AIM框架被证明是指导这一实施评估的适当和全面的框架.
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