开发和实施老年人老年手术联合管理计划:从文档分析的见解

Abigail Baim-Lance1,2, Fred Ko1,2, William Hung1,2

  • 1Icahn School of Medicine at Mount Sinai, New York (NY).

PubMed

The衰老、生命创新、目标与需求——协作实现准备就绪与赋能(ALIGN-CARE)门诊老年外科共管是一种多学科协作项目,旨在更好地为体弱的老年患者进行术前准备。我们采用医学研究理事会(MRC)评估框架、文件审查以及项目会议分析,对该复杂临床项目的开发与实施过程进行了研究。我们分析了2020年1月至2022年1月期间召开的四种定期会议(咨询会、多学科会、外科医生会和研究会)所产生的84次会议记录(共计81.5小时)。通过对文档进行编码和主题分析,构建了项目的实施时间线、不断演进的项目组成部分以及支持项目发展的实施过程。ALIGN-CARE逐步发展并稳定形成了四个明确的环节(转诊、排程、评估和计划),并依托多种实施策略推进。各类会议以不同方式推动了项目进程。项目的灵活性与响应能力是推动实施的关键因素。ALIGN-CARE通过不断调整项目环节实现成熟发展,利益相关方会议有力支持了这些目标的达成。该文档分析方法识别出发展老年外科共管及推进面向老年人群的复杂多学科项目所需的关键流程。

相关概念视频

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
219
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
183
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
852
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
236
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
223
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
194