通过积极的社会工作者沟通来提高质量改善努力,以加强缓和护理的获取
Ellis C Dillon1, Amandeep Grewal2, Su-Ying Liang2
1Center on Aging, University of Connecticut, Farmington, CT.
JCO oncology practice
|July 25, 2025
概括
一个由社会工作者领导的质量改善项目没有显著增加晚期癌症患者的息治疗 (PC) 转诊. 现实世界的实施挑战可能会影响干预的有效性.
科学领域:
- 在瘤学瘤学.
- 医疗服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 对于晚期癌症患者来说,获得专门的息治疗 (PC) 是非常重要的.
- 质量改进项目旨在弥合基于证据的PC和现实世界的应用之间的差距.
- 正在探索由社会工作者领导的干预措施,以加强PC访问.
研究的目的:
- 评估一项旨在增加晚期癌症患者获得专业息治疗 (PC) 的质量改善计划.
- 评估由社会工作者领导的计划对PC推和利用的影响.
主要方法:
- 一项差异分析比较了社会工作者领导的PC干预站点和使用常规护理的三个控制站点.
- 治疗意图分析检查了PC转诊 (主要结果) 和生命终结结果的变化.
- 使用多变量后勤和Poisson回归来比较实施前和后的结果.
主要成果:
- 与对照地点 (26.7%至25.3%) 相比,干预地点的PC转诊率略有增加 (30.4%至32.7%).
- 干预地点的PC访问量增加,死者的访问量显著增加 (53.1%至75%).
- 经过调整后的分析显示,在干预地点死亡前,PC访问的增加趋势几乎显著 (OR,3.09;P = .07).
结论:
- 社会工作者主导的干预与息治疗转诊的统计学上显著增加无关.
- 将基于证据的PC干预转化为现实世界的质量改进,需要仔细考虑上下文和潜在的修改.
- 需要进一步的研究,以优化社会工作者领导的PC倡议在各种医疗保健机构的有效性.
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