改变基于社区的康复服务:使用基于经验的共同设计进行国家重新设计
Shamala Thilarajah1,2,3, Karina Dancza2,3, Zhen Zhen Chen2,4
1Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
概括
基于经验的共同设计 (EBCD) 改善了新加坡中风,虚弱和关节骨折患者的社区康复. 这种以患者为中心的方法确定了改善服务流程和临床护理的关键领域.
科学领域:
- 老年学和康复医学 老年学和康复医学
- 医疗保健服务研究 医疗服务研究
- 患者和公众参与医疗保健
背景情况:
- 社区日间康复中心 (DRC) 对中风后的康复,骨折和骨折的恢复至关重要.
- 了解客户,护理人员和工作人员的经验对于改善康复服务至关重要.
- 一个国家质量改进项目,旨在加强新加坡的社区康复.
研究的目的:
- 探索新加坡民主共和国的客户,护理人员和工作人员的经验.
- 确定改善服务流程和治疗中风,骨折和关节骨折的临床护理的领域.
- 通过基于经验的共同设计 (EBCD) 共同设计基于社区的康复的系统级变化.
主要方法:
- 2,6年来采用多阶段的EBCD方法,包括观察,采访和反事件.
- 利用基于客户/护理人员经验的12分钟触发影片来促进讨论.
- 收集定量 (调查) 和定性 (采访,案例笔记) 数据,以评估基于指南的护理服务.
主要成果:
- 参与了80多名客户/护理人员和250名员工在20个刚果民主共和国.
- 确定了关键主题:最佳实践护理,以人为中心的护理,相关的卫生专业需求和服务设计.
- 以人为中心的护理是优先考虑的,但因安排和营业额而受到挑战;护理部分符合指导方针;确定了加强直接护理,教学和研究的机会.
结论:
- EBCD有效地发现了服务缺口,并促进了社区康复系统级解决方案的共同设计.
- 该研究强调了需要进一步的组织和个人层面的改进.
- 患者和公共合作伙伴在塑造研究和推动医疗保健改进方面发挥了宝贵的作用.
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