评估反报告,以支持记录退伍军人在家庭初级保健中的护理偏好
Cari Levy1,2, Jennifer Kononowech3, Mary Ersek4,5
1Denver-Seattle VA Center of Innovation for Value Driven & Veteran-Centric Care, Rocky Mountain Regional VA Medical Center at VA Eastern Colorado Health Care System, Aurora, CO, USA.
BMC geriatrics
|May 1, 2024
概括
月度反报告没有改善VA家庭初级保健 (HBPC) 团队中维持生命治疗决策 (LST) 文件完成率. 国家实施战略,而不是反报告,可能推动了LST笔记完成的总体增加.
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
- 抚慰性护理是一种缓解性护理.
背景情况:
- 生命维持治疗决策倡议 (LSTDI) 于2017年在退伍军人卫生管理局 (VHA) 实施,以记录重病退伍军人的护理目标.
- 退伍军人家庭初级保健 (HBPC) 团队对于为患有严重疾病的退伍军人提供护理至关重要.
研究的目的:
- 评估是否提供反报告提高了VA HBPC团队中生命维持治疗 (LST) 备忘录的完成率.
- 评估反报告的有效性作为一个独立的实施策略.
主要方法:
- 从2018年10月到2020年2月,关于LST模板完成的每月反报告被发送到13个HBPC干预地点.
- 主要组件分析将干预地点与26个比较地点相匹配;中断时间序列/分段回归分析评估了完成率差异.
- 混合方法方法包括提取国家数据库,采访和调查以评估过程.
主要成果:
- 在研究期间,所有HBPC团队的LST模板完成率从6.3%增加到41.9%.
- 在收到反报告的干预站点和比较站点之间没有观察到LST模板完成率的统计学上显著差异.
- 总体完成率的增加可能受到国家LSTDI实施战略的影响.
结论:
- 仅靠反报告并不是增加HBPC团队中LST文档的有效策略.
- 观察到的LST笔记完成率的上升是由于LSTDI在全国范围内更广泛的实施努力.
- 在这种情况下,反报告可能不足以补充现有的国家实施战略.
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