扩大装备药物安全计划的规模:传统和枢纽和分支实施模式
Ann E Vandenberg1, Ula Hwang2,3, Shamie Das1
1Division of Geriatrics & Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Journal of the American Geriatrics Society
|January 23, 2024
概括
装备计划成功地减少了从急诊部 (ED) 出院的老年人的潜在不合适药物 (PIM). 传统的和枢纽式的模型都被证明是有效的扩展这种药物安全倡议.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 药物安全 药物安全
背景情况:
- 装备计划是一个以证据为基础的倡议,旨在减少可能不适合的药物 (PIM) 在老年人 (65+) 从急诊室 (ED) 出院.
- 扩展EQUIPPED计划涉及一个ED的传统模式和卫生系统内的其他三个ED的枢纽型模型.
研究的目的:
- 通过使用传统和枢纽和分支实施模型,评估扩展EQUIPPED计划的有效性.
- 确定中心和分支模型是否增加了实施速度,而不影响PIM减少或现场参与.
主要方法:
- 在12个月期间,在装备实施之前和之后对PIM率的比较评估.
- 评估不同ED站点和模型的实施时间,促进者和障碍.
- 分析处方数据和定性访谈数据,以了解实施经验.
主要成果:
- 所有四个地点都显示,在EQUIPPED实施后,PIMs显著减少.
- 实现时间在传统模型和集线器模型中都是可比的.
- 由于冠军角色范围,枢纽和扬声器模型在发言地点面临不成比例的参与障碍.
结论:
- 在COVID-19疫情期间,EQUIPPED计划在两种模式下成功地在四个新地点实施.
- 枢纽和光圈模型是扩展EQUIPPED的可行策略,尽管没有观察到速度或质量优势.
- 证实了EQUIPPED对复杂现实环境的适应性.
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