初级保健团队配置对获得和护理质量的影响
Sylvia J Hysong1,2, Kelley Arredondo3,4,5,6, Houston F Lester3,7
1Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. hysong@bcm.edu.
优化初级保健团队的人员配置对于医疗保健的获取和质量至关重要. 足够的全职同等 (FTE) 人员能力是必不可少的,尽管团队规模和角色多样性对患者护理结果产生了不同的影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 医疗保健管理的管理
背景情况:
- 基于团队的初级保健在大型医疗保健系统中很普遍.
- 初级保健团队的最佳人员配置模式缺乏明确的指导.
研究的目的:
- 调查初级保健团队人员配置和患者获得护理的关系.
- 检查团队人员配置和临床质量结果之间的关联.
主要方法:
- 一项观察性研究利用了2020年2月的退伍军人卫生管理局 (VHA) 数据.
- 在1050个VHA设施的7050个团队中分析了22390名人员的数据.
- 通过网络分析和多层次模型,评估团队人员是否遵守VHA指南,包括人员数量 (FTEs) 和角色多样性.
主要成果:
- 团队规模和FTE的变化表明没有遵守VHA指南.
- 遵守指南与访问或质量没有相关性.
- 较高的FTE通常与更好的结果相关;增加的角色多样性显示出混合的结果.
- 较大的团队改善了出院后的联系,但减少了预约的可用性.
结论:
- 为了获得高质量的初级保健服务,需要最低限度的FTE员工能力.
- 需要进一步的研究来优化根据特定职位角色的员工配置.
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