设计复杂的护理管理计划,以支持患有物质使用障碍的患者:一个必不可少和被忽视的机会
Kelly M Schuering1,2, Daniel P Martin1, Deborah Goldfarb1,3
1Population Health Services, Boston Medical Center (Drs Schuering, Martin, Ms Goldfarb, Ms Nahrgang, Drs Galbraith, and Pace), Boston, MA.
护理管理计划可以改善物质使用障碍 (SUD) 患者的治疗结果. 调整人员和培训可以提高患者的参与度,并降低过量服用率,尽管需要进一步的研究.
科学领域:
- 医疗保健管理的管理
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
背景情况:
- 有物质使用障碍 (SUD) 的个人经历了显著的健康并发症和高的医疗保健费用.
- 医疗补助负责任护理组织 (ACO) 可以从改善SUD患者的护理管理中受益.
- 关于将SUD护理纳入现有管理计划的有效策略的报告有限.
研究的目的:
- 描述波士顿医疗中心卫生系统综合护理管理 (CCM) 计划所做的调整,以更好地为SUD患者提供服务.
- 概述在医疗补助 (Medicaid) ACOs中加强SUD患者的护理管理能力的战略.
主要方法:
- 调整了人员配置模型,招聘和培训,专注于SUD,减少伤害,激励面试和创伤信息护理.
- 在住院和社区环境中嵌入员工,可以获得行为健康支持.
- 与社区,政府和医疗保健组织建立了合作伙伴关系,以协调综合护理.
- 实施患者识别,参与和解决与健康相关的社会需求的战略.
主要成果:
- 大多数SUD患者在外展后同意CCM招募,这表明了改善覆盖范围和持续参与的潜力.
- 初步数据显示,CCM注册患者的过量剂量率较低.
- 参与CCM的患者表现出更高的参与SUD,心理健康和阿片类药物使用障碍药物治疗的门诊护理.
结论:
- 护理管理人员,有适当的培训和工具,可以显著改善SUD患者的结果.
- CCM计划的调整表明了支持这种急需人口的可行模式.
- 需要进一步的研究来评估干预组件对患者结果的具体影响.
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