直接招生计划的实施:对整个卫生系统的差异进行定性分析
Jordan A Taylor1, Corrie E McDaniel2,3, Cathryn A Stevens4
1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Pediatrics
|March 27, 2024
概括
直接招生 (DA) 计划在整个卫生系统中显示了可变的采用. 实施挑战和临床医生信任影响计划的成功,为改善医院过渡提供了见解.
科学领域:
- 医疗保健管理的管理
- 实施科学 实施科学
- 患者体验 患者体验
背景情况:
- 直接入院 (DA) 绕过急诊室,有可能提高患者满意度和护理及时性.
- 了解DA计划实施的变化对于优化医疗保健服务至关重要.
研究的目的:
- 描述DA计划在整个卫生系统的覆盖范围,有效性,采用和实施.
- 探索使用RE-AIM框架对DA计划的家长和临床医生的观点.
主要方法:
- 一个阶梯集群随机试验评估了DA的有效性.
- 用主题和轴向编码分析了137名家长和临床医生的半结构面试.
主要成果:
- 在卫生系统中,DA率变化10倍 (0.9%9.3%),2599例住院病例中有6.6%通过DA.
- 在感知有效性和参与度方面注意到了相似之处,但实施和采用情况各不相同.
- 转移中心效率,临床医生信任和组织文化的差异影响了采用.
结论:
- 达计划的采用是不一致的,呈现独特的实施挑战和机会.
- 结果可以指导质量改进计划,以实现更顺的医院过渡.
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