排放过渡计划中的异质性和不一致的激励措施:来自多站点快速定性研究的见解
Himali Weerahandi1, Mark V Williams2, Molly A Rosenthal3
1Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA.
Journal of hospital medicine
|January 14, 2026
概括
护理过渡 (ToC) 计划面临重大障碍,包括碎片化和未能满足患者需求. 提高患者安全需要解决与健康相关的社会需求 (HRSNs) 并优先考虑以患者为中心的护理.
科学领域:
- 医疗保健提供研究 医疗保健研究
- 患者安全倡议 患者安全倡议
- 医疗服务研究 医疗服务研究
背景情况:
- 护理过渡 (ToC) 计划对于患者安全至关重要,但在美国医院中表现出不同的成功.
- 多种疾病和与健康相关的社会需求 (HRSNs) 对ToC计划的实施构成独特的挑战.
- 医院医生是出院规划的关键利益相关者,并识别有效ToC的障碍.
研究的目的:
- 调查医院医生对 ToC 计划的成功,失败和实施障碍的看法.
- 了解从医院到社区环境的过渡中的挑战.
主要方法:
- 采用了快速定性研究设计.
- 虚拟聚焦小组与来自医院医学改造网络 (HOMERuN) 的参与者进行了讨论.
- 一个混合的归纳-归纳框架促进了数据分析和主题识别.
主要成果:
- 来自19个组织的22名医院医生参与了;没有全面的ToC计划被普遍提供.
- 关键主题包括:特定于诊断的项目导致了分裂,出院后的随访障碍 (约会,保险,地理),以及对患者偏好,HRSN,健康素养,资源和领导力的不充分关注.
- 成功的计划需要机构承诺,资金,专业间合作和社区参与,重点关注以患者为中心的护理,而不是金融ROI.
结论:
- 目前的ToC计划是分散的,危及安全和公平的患者过渡.
- 解决HRSN,确保领导支持,并优先考虑以患者为中心的护理对于提高ToC结果至关重要.
- 超越短期财务目标,朝着患者福祉迈进,对于有效的护理过渡至关重要.
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