在内科住院连续性诊所实施以团队为基础的护理:两年的变化
Peter J McDonnell1, Stephen Fuest2, Nickole Forget1
1Division of General Medicine and Geriatrics, Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
实施连续性诊所团队显著改善了住院医生的初级保健经验. 这次重组提高了患者护理质量和支持,不需要额外的教师,为其他培训诊所提供了一个模型.
科学领域:
- 医学教育 医学教育
- 主要护理是指初级护理.
- 卫生系统研究 卫生系统研究
背景情况:
- 连续性诊所团队结构对住院医生的初级保健经验的影响还不清楚.
- 之前关于团队形成的研究与调度或医疗家庭模型的变化同时发生.
- 内科住院诊所报告住院经验不佳,理由是缺乏足够的支持,患者护理安全网和教师监督.
研究的目的:
- 评估实施团队组建对内科医生住院连续性诊所经验的影响.
- 评估居民对患者护理质量,支持和整体体验的看法变化.
主要方法:
- 一个单一的城市学术医疗中心在其内科住院连续性诊所中实施了基于团队的模型.
- 12个团队,每个团队都有一个主要的参与者和11-12名居民,在2020学年后组建.
- 实施前和后的调查 (2019-2020年与2021-2022年) 评估了居民的经验.
主要成果:
- 该研究实现了74.3%的响应率 (422名居民中有313人).
- 团队实施与改善患者护理和支持的感知质量有关.
- 在连续性诊所的整体住院经验显著改善.
结论:
- 通过重组现有资源实现的团队组建,大大提高了初级保健居民连续性诊所的经验.
- 这种改进独立于区块调度带来的好处.
- 该模型为培训诊所提供了一种可行的策略,可以在不增加教师人数的情况下改善住院门诊体验.
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