荷兰大学医院向基于价值的医疗保健转变十年:一个复杂性知情的过程研究研究
Veerle van Engen1, Martina Buljac-Samardzic2, Rob Baatenburg de Jong3
1Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. vanengen@eshpm.eur.nl.
Health research policy and systems
|August 5, 2024
概括
基于价值的医疗保健 (VBHC) 的实施需要一种混合战略,将深层次的本地变革与广泛的,系统集成的努力相结合. 这种方法,而不是线性规划,促进大规模的转型,并为成功的医疗保健进化拥抱复杂性.
科学领域:
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 组织变革 组织变革
背景情况:
- 全球各地的医疗机构正在采用基于价值的医疗保健 (VBHC).
- 对于如何有效地实现这种范式转变,存在有限的见解.
- 这项研究调查了荷兰一所大学医院十年的VBHC实施情况.
研究的目的:
- 检查VBHC实施策略的演变.
- 了解这些变化的结果和潜在逻辑.
- 为在医疗保健机构成功采用VBHC提供见解.
主要方法:
- 追溯的,复杂性知情的过程研究.
- 对广泛的医院文件 (10,536项) 的分析.
- 利用实施结果指标 (4),临床医生调查 (47) 和采访 (20).
主要成果:
- VBHC的实施是通过三个策略发展的:深度本地,广泛的进化和当前的混合方法.
- 混合战略结合了深入和广泛的变革努力,将VBHC整合到IT和政策中.
- 到2023年,68个部门参与了VBHC,使用患者报告结果措施 (PROM),尽管临床医生的采用情况各不相同.
结论:
- VBHC的实施不是线性或易于扩展的;混合方法是有利的.
- 协调,系统集成的局部变化推动了大规模的转型.
- 拥抱复杂性,专注于 (再) 制度化和 (再) 专业化是VBHC成功的关键.
相关概念视频
01:27Fundamentals of Nursing Process I
6.1K
The nursing process is the core of practice for every registered nurse to deliver holistic, patient-focused care. The following are the five steps in the nursing process.
6.1K
01:20Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
1.7K
Evaluation of the teaching process enables the nurse to determine if the patient's learning needs were met and if training was effective. If the expected outcomes are not met, the care plan is revised, and additional education or reinforcement is provided. Nurses can ask questions after the session or obtain feedback to assess the patient's understanding of the topic.
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
1.7K
01:25Fundamentals of Nursing Process II
3.5K
There are several characteristics related to delivering nursing care. One vital characteristic of the nursing process is that it can be used to protect nurses and justify the provided care. Productive use of the nursing process requires the knowledge and skills of nurses to assess and solve issues. Nurses should develop and strengthen their critical thinking skills and evidence-based nursing interventions to improve their skills in formulating nursing care plans. A well-defined approach to...
3.5K
01:30Health Information Technology and Healthcare Information System
812
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
812
01:08Role of Communication in the Nursing Process III: Evaluation and Documentation
1.3K
A successful patient outcome depends mainly on the evaluation stage of the nursing process. Evaluation determines effectiveness by reviewing what was done previously after the completion of nursing interventions. Every time a healthcare professional steps in or administers treatment, they must reassess or evaluate the action to ensure the intended result. During the evaluation phase, there are three probable patient outcomes:
1.3K
01:11Purpose of Health Records I
1.2K
The vital purpose of health records is to provide a complete and accurate account of a patient's medical history, including communication, diagnostic and therapeutic orders, care planning, research, and quality review.
Here's a breakdown of how health records serve these purposes:
Here's a breakdown of how health records serve these purposes:
1.2K