在临床环境中解决社会需求:从负责任的卫生社区中吸取早期教训
Laura B Beidler1, Jeffery D Colvin2, Courtney M Winterer2
1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA.
新的质量指标鼓励医院选与健康相关的社会风险. 负责任的健康社区 (AHC) 模型为有效的查,转诊和导航提供了洞察力,以改善患者的社会需求.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 健康的社会决定因素
背景情况:
- 医疗保险和医疗补助服务中心 (CMS) 现在要求在医院对与健康有关的社会风险进行查.
- 该计划旨在将有社会需求的患者与社区资源和导航服务联系起来.
- 负责任的健康社区 (AHC) 模式是这些查,转诊和导航策略的基础.
研究的目的:
- 为实施社会风险查,转诊和导航活动的医疗保健组织提供指导.
- 确定关键的程序设计元素,以促进在医疗保健机构内的社会护理活动的实施.
- 为可持续和有效的社会护理倡议提供政策和计划设计的信息.
主要方法:
- 定性研究涉及采访31名参与者中的22名参与者在2019年问责健康社区 (AHC) 模型中.
- 分析采访数据,以确定实施社会护理活动的促进者和障碍.
- 主题分析以提取关键的程序设计元素.
主要成果:
- 四个关键的程序设计元素促进了AHC的实施:集中管理,问责性里程碑,规范性要求和技术支持.
- 虽然AHC模型结构促进了社会护理活动的快速实施,但它缺乏持续采用的灵活性.
- 集中管理办公室对于有效实施至关重要,但往往与临床场所无关,阻碍了工作流集成和长期可持续性.
结论:
- 医疗机构可以利用AHC模型的见解来设计和实施有效的社会护理计划.
- 需要在规范性要求和灵活性之间保持平衡,以实现社会护理活动的可持续采用.
- 未来的社会护理计划设计应考虑将集中管理功能集成到临床工作流程中,以提高可持续性.
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