在现实世界实践中学习:确定实施策略,将与健康相关的社会需求查整合到一个大型卫生系统中
Kevin Fiori1,2,3, Samantha Levano1,2, Jessica Haughton1,2
1Department of Family & Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Journal of clinical and translational science
|November 29, 2023
概括
实施有针对性的战略,如患者门户和社区卫生工作者,显著增加了与健康相关的社会需求 (HRSN) 查. 这表明了对普遍查和解决健康的社会决定因素的承诺.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 健康 公平 卫生 公平
背景情况:
- 越来越多的证据将健康的社会决定因素与患者的结果联系起来.
- 新的法规要求采取健康公平措施,鼓励对与健康相关的社会需求 (HRSN) 的查.
- 大型城市卫生系统在扩大HRSN查计划方面面临挑战.
研究的目的:
- 描述一个大型城市卫生系统在扩大HRSN查方面的经验.
- 确定有效的实施策略,以提高HRSN查率.
- 评估这些战略在五年内 (2018-2023) 的影响.
主要方法:
- 在2018年调整了10项HRSN查工具.
- 使用"实施变革的专家建议" (ERIC) 框架对实施战略进行分类.
- 利用统计过程控制方法来评估战略的有效性.
主要成果:
- 在311个临床团队中进行了超过28万次HRSN查.
- 增加查的关键策略包括患者门户集成,团队扩展,数据反循环和部署社区卫生工作者.
- 这些策略与查活动的显著改进有关.
结论:
- 专注于效率,普遍选,资源链接和易于集成的实施策略是最具影响力的.
- 持续增加的查强调了这些策略的累积效应.
- 卫生系统表现出强烈的承诺,以实现普遍的HRSN查.
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