团队和电子健康记录的特点和家庭医生中的倦怠
Lisa S Rotenstein1,2,3, Nathaniel Hendrix4, Robert L Phillips4
1Division of Clinical Informatics, Department of Medicine, University of California, San Francisco.
JAMA network open
|November 5, 2024
概括
家庭医生经历的燃烧程度较低与高效的初级保健团队和适当的电子健康记录 (EHR) 使用有关. 优化团队支持和EHR工作流程可以改善医生福祉和实践可持续性.
科学领域:
- 主要护理是指初级护理.
- 医疗保健服务研究 医疗服务研究
- 医生福利 医生福利
背景情况:
- 越来越多的电子健康记录 (EHR) 需求和流行后的员工挑战对家庭医生产生了影响.
- 对于卫生系统领导者来说,了解不断变化的倦怠趋势及其决定因素至关重要.
- 提高家庭医生经验对于初级保健的可持续性至关重要.
研究的目的:
- 评估家庭医生对团队结构的看法与EHR与倦怠的经历之间的关系.
- 识别影响团队动态和EHR效率的可修改的实践因素.
- 为减轻医生倦怠提供基于证据的策略.
主要方法:
- 从2016年12月到2023年10月进行的连续横截面调查研究.
- 包括寻求通过美国家庭医学委员会获得持续认证的家庭医生.
- 多变量后勤回归分析以检查倦怠,团队效率和电子健康记录体验之间的关联.
主要成果:
- 在2017年至2022年期间,倦怠率从37.9%到42.8%不等,没有显著的时间趋势.
- 适当的家庭电子健康记录使用 (OR 0.58) 和高团队效率 (OR 0.61) 与更低的倦怠率有显著的相关性.
- 与注册护士的合作提高了团队效率 (OR 1.35),与医生助理的合作改善了EHR时间 (OR 1.13).
结论:
- 优化初级保健团队的支持和家庭医生的电子健康记录经验可以减少倦怠.
- 这些发现强调了需要进行系统变革,以提高初级保健的可持续性.
- 临床领导者和决策者应优先考虑针对团队效率和EHR工作流程改进的干预措施.
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