一个定性系统模型,用于描述频繁的潜在可避免的呈现给急诊部的原因和驱动因素
Mary Malakellis1, Anna Wong Shee1,2, Margaret Murray1
1Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia.
Heliyon
|November 29, 2023
概括
频繁的,可能可以避免的急诊室 (ED) 访问是复杂的. 解决方案需要通过系统和个人层面的干预来解决访问,协调,患者需求和知识差距的问题.
科学领域:
- 公共卫生 公共卫生
- 系统科学 系统科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 频繁的,可能可以避免的紧急诊所 (ED) 呈现是一个复杂的医疗保健挑战.
- 这些呈现受到多个相互关联的因素的影响,这些因素随着时间的推移而演变.
- 了解这些驱动因素对于在区域卫生系统中制定有效干预措施至关重要.
研究的目的:
- 描述和绘制区域卫生系统中经常出现可能可避免的ED表现的驱动因素.
- 从关键利益相关者的角度确定潜在的解决方案.
- 为减少ED负担提供有针对性的干预信息.
主要方法:
- 使用集团模型构建 (GMB) 的定性,基于社区的系统动态方法.
- 两个在线研讨会 (n=29和n=21) 涉及区域卫生系统内的各种利益相关者.
- 制定因果循环图 (CLD) 和优先行动清单,根据公共卫生框架进行评估.
主要成果:
- 一个CLD确定了四个关键驱动类别:获得服务,协调,患者需求和知识/技能.
- 确定了9个行动领域,重点关注护理和服务协调.
- 大多数拟议的行动与较低层次的系统干预措施保持一致,表明需要更高层次的影响策略.
结论:
- 频繁的可能可以避免的ED表现是一个多方面的问题,需要综合解决方案.
- 预防策略必须解决系统层面的因素和个体患者的需求.
- 进一步确定行动的优先级是必要的,以实现可持续变革的更高层次系统影响.
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