一项定性研究检查了在新加坡实施病例管理团队以减少可避免的医院再入院的意外后果
Shilpa Surendran1, Stephen So2, Toon Wei Lim3
1Health Services and Systems Research, Duke-NUS Medical School, Singapore.
Health services insights
|May 5, 2025
概括
实施试点病例管理团队以减少住院再接收,由于资金问题和患者困惑等意想不到的后果而失败. 这些因素削弱了干预的作用.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 医疗保健服务研究 医疗服务研究
背景情况:
- 住院再接收是一个重大挑战,促使开发各种干预措施.
- 由于潜在的意外后果,评估这些干预措施的有效性是复杂的.
- 意外后果是医疗保健机构干预失败的常见原因.
研究的目的:
- 为了确定从试点案例管理团队干预中产生的意外后果.
- 该干预旨在减少新加坡一家三级医院的可避免的住院再诊.
主要方法:
- 雇佣了与参与干预的关键利益相关者进行半结构化访谈.
- 分析了12份与干预有关的文件.
- 利用罗杰斯的创新传播理论指导的演性主题分析.
主要成果:
- 确定了七个不预期后果的子主题:无效的患者定位,资金限制,缺乏患者所有权,限定的出院后后续,综合护理方法,角色重叠和患者混.
- 再接收风险工具的缺失导致了广泛的评估,压倒性的护理协调.
- 资金限制阻止了专门团队的形成,导致咨询角色和评估的远程支持.
结论:
- 案例管理团队认识到问题,并参与了干预,形成了变革的基础.
- 意想不到的后果严重阻碍了干预的目标,导致其停止.
- 决策者必须考虑这些意想不到的后果,以改善未来的干预设计和实施,以减少再入院.
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