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超越解决方案:改善住院医疗轮换的教育,护理和健康 - - 多中心定性研究
John Ratelle1, Erin Spicer2, Kristen A Bishop3
1Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA. Ratelle.John@mayo.edu.
Journal of general internal medicine
|April 15, 2025
概括
由于工作量增加,医生领导者在住院医疗轮换期间面临着平衡教育和患者护理的挑战. 一个新的模型有助于优化结构和流程,以改善护理,教育和临床医生健康.
科学领域:
- 医学教育 医学教育
- 医疗保健管理的管理
- 临床实践 临床实践
背景情况:
- 住院医疗轮换 (IMR) 对于临床教育和患者护理至关重要.
- 越来越多的工作负载和快节奏的环境威胁到IMR的双重目标.
- 在IMR中,教育目标和临床需求之间出现了紧张关系.
研究的目的:
- 探索在IMR中平衡教育和临床实践的挑战.
- 了解医生领导者如何应对这些相互竞争的需求.
- 确定优化IMR学习环境的策略.
主要方法:
- 构造主义的立足理论方法.
- 与来自美国和加拿大的20个学术医疗中心的27名领导医生进行了半结构面试.
- 代的数据分析,以开发一个概念模型,通过不断的比较和三角化来增强.
主要成果:
- 参与者认识到IMRs的价值,但强调了工作负载和资源问题如何造成影响护理,教育和健康的紧张局面.
- 反应性的"规避方法"很常见,但往往会导致意想不到的后果.
- 确定了IMR成功的六个关键类别:患者组合/人口普查,领导协作,协作护理模型,安排,临床工作流程和教育工作流程.
结论:
- IMRs面临着不断变化的临床和教育环境带来的重大挑战.
- 一个具有可修改变量的概念模型为领导医生提供了一个框架,以增强IMRs.
- 优化IMR可以促进高质量的护理,教育和临床医生的健康.
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