减少急诊室转移和建立长期护理家庭能力的计划:混合方法研究
Geetha Mukerji1, Leahora Rotteau2, Joanne Goldman3
1Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Journal of the American Medical Directors Association
|February 11, 2025
概括
长期护理加 (LTC+) 计划并没有显著减少急诊室的转移,这可能是由于流行病的影响. 然而,它提高了长期护理中心的能力,并提高了为客户提供以客户为中心的护理的自我效能.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 从长期护理院转移到急症医院对居民构成风险.
- 随着COVID-19的流行,人们需要创新的解决方案来管理长期护理机构内的住院护理.
研究的目的:
- 评估长期护理+ (LTC+) 计划对减少急诊室 (ED) 从长期护理院 (LTCH) 转移的影响.
- 探索参与者的看法和影响LTC+计划采用的上下文因素.
主要方法:
- 在加拿大多伦多的54个LTCH中进行了一项混合方法研究.
- 统计过程控制图分析了ED转移率,比较高和低吸收的LTCH.
- 对与医疗保健提供者,管理人员,住户和护理人员进行的半结构化访谈进行主题分析,探索了计划经验.
主要成果:
- 在研究期间,在9658个ED转移中,有40%不需要入院.
- 在LTC+计划中,提供了534次虚拟咨询,其中5次LTCH占使用率的59%.
- 总体而言,ED转移率与基线相比下降了40%,高LTC+采用设施和低LTC+采用设施之间没有明显差异.
结论:
- 在LTC+计划中,没有证明ED转移的减少超出了与流行病相关的趋势.
- 参与者报告了除了避免ED之外的好处,包括增加LTCH内部的自我效能和能力.
- 建议对计划进行改进和结构变化,以加强LTC+对居民护理和转移减少的影响.
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