鉴定影响医院出院决策新兴创新的因素,以应对系统压力:一个定性研究
Allison M Gustavson1,2, Matthew J Miller3, Natassia Boening4
1Veterans Affairs Health Services Research and Development Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, 55417, USA. Allison.Gustavson@va.gov.
BMC health services research
|October 29, 2024
概括
在COVID-19期间,康复临床医生迅速创新了出院流程,加强了协作和远程医疗. 这些调整涉及系统变化,但未来的研究应该评估它们的长期影响和实施.
科学领域:
- 医疗保健提供 医疗保健提供
- 康复医学 康复医学 康复医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 冠状病毒2019 (COVID-19) 流行病需要医疗保健的快速适应.
- 医院出院决策过程受到大流行相关变化的重大影响.
研究的目的:
- 在COVID-19大流行期间识别新兴的康复创新.
- 了解临床医生对影响这些创新的实施和结果的因素的看法.
- 探索医院出院决策中的变化.
主要方法:
- 这项定性研究涉及来自退伍军人事务医疗保健系统的23名康复临床医生 (11名理疗师,12名职业治疗师).
- 半结构面试以整合促进卫生服务研究实施行动 (i-PARIHS) 框架为指导.
- 快速定性,演性的基于团队的数据分析,使用定向内容分析.
主要成果:
- 创新包括增加团队协作,案件负载优先级的转变,以及急性后替代性护理选择.
- 沟通方式的变化 (从面对面到虚拟) 和患者对家庭出院的偏好影响了目标设定.
- 系统背景,跨学科动态和政策波动塑造了创新.
- 具体的创新包括协作技术,家庭护理的远程医疗,急性护理优先级的变化以及直接到家出院的选择.
结论:
- 康复临床医生展示了在COVID-19大流行期间适应系统级变化的创新策略.
- 需要进一步的研究来评估这些创新的影响和意外后果.
- 评估有前途的创新实施对于未来的医疗保健提供需求至关重要.
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