在退伍军人卫生管理局的跨学科初级保健环境中实施基于视频的护理:定性研究
Claudia Der-Martirosian1,2, Cynthia Hou1, Sona Hovsepian1
1Veterans Affairs Greater Los Angeles Healthcare System Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, United States.
在初级保健中视频远程医疗的实施受到患者需求,技术获取,员工角色,组织支持和适应能力的影响. 这些因素是维持和改善虚拟护理服务的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康实施方案
- 初级保健创新初级保健的创新
背景情况:
- 远程医疗的快速采用造成了关于其在跨学科初级保健 (PC) 中的实施的知识差距.
- 在PC环境中了解基于视频的护理服务对于优化虚拟健康服务至关重要.
- 退伍军人卫生管理局 (VHA) 提供了一个独特的环境来研究大规模的远程医疗实施.
研究的目的:
- 从患者和跨学科团队的角度探索在初级保健中实施视频远程医疗服务.
- 在VHA中识别基于视频的护理采用和可持续性的促进者和障碍.
- 为改善PC环境中的视频远程医疗服务提供见解.
主要方法:
- 使用正负偏差方法在VHA中选择使用高和低视频的PC网站.
- 对43名PC跨学科团队成员和12个VHA站点的25名患者进行了采访.
- 创新传播理论和非采用,放弃,扩大,扩散和可持续性 (NASSS) 框架指导数据收集和分析.
主要成果:
- 在五个NASSS领域出现了关键主题:患者特征 (访问类型,健康状况,人口统计),技术 (访问,知识,支持),采用者系统 (角色变化,偏好,护理人员参与),医疗保健组织 (领导,资源,安排,培训) 和随着时间的推移 (改进能力,沟通) 的适应.
- 患者因素,如访问目的和家庭状态,技术可访问性,员工舒适性,组织领导力和持续适应性,显著影响了视频远程医疗的实施.
- 有效的协调,培训和可访问的技术支持对于成功的基于视频的护理提供至关重要.
结论:
- 与患者,技术,采用者,组织和适应相关的多个因素影响了VHA初级保健中的视频远程医疗实施.
- 这些发现可以为维持和增强VHA和其他以患者为中心的医疗机构的基于视频的护理策略提供信息.
- 对这些多面因素的全面理解对于优化虚拟护理提供至关重要.
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