大流行病行动计划:第 3 阶段--从实施中学到的经验教训。"我们学到了什么?

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Telemedicine and e-Health Pub Date : 2024-10-01 Epub Date: 2024-07-04 DOI:10.1089/tmj.2023.0248
Mark Vanderwerf, Doris T Barta, Carl W Taylor, Cara B Towle, Kathy Hsu Wibberly, Jordan Berg, Costi Sifri, Douglas L Moore, Tim Collins, Ken Feiler, A Stewart Ferguson, Garret Spargo
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引用次数: 0

摘要

COVID-19 大流行给医院和医疗服务提供者带来了严峻的挑战。诊所突然被迫关闭;择期手术被推迟;预定就诊被取消;急诊室人满为患;医院床位、设备和个人防护设备(PPE)供不应求;工作人员面临着快速变化的环境、护理方案、创伤和个人风险。为了更好地应对正在发生的 COVID-19 大流行所带来的挑战,并为未来的大流行做好准备,国家远程医疗技术评估资源中心 (TTAC) 被要求制定一项大流行应对行动计划,使其用户能够利用现有的远程医疗和相关技术解决关键问题。该项目分为三个阶段。第 1 阶段-制定《大流行病应对行动计划》和《大流行病应对行动计划政策和监管摘要》,其中确定了监管挑战和政策建议。第 2 阶段-发布行动计划和政策法规摘要。第 3 阶段-对使用《大流行病行动计划》中的方法、工具和技术的医疗保健提供者进行调查,并将结果记录在案。本文件代表第 3 阶段。本文件为第 3 阶段。在本报告中,我们回顾了在第 2 阶段公布的第 1 阶段大流行病应对行动计划中使用方法的医疗服务提供者。在本文件中,我们报告了实施《大流行病应对行动计划》部分内容所面临的挑战和取得的成果。它记录了医疗服务提供者的经验以及团队及其组织在实施部分或全部计划过程中的专业经验所产生的结果、结论和建议。方法:编写第 3 阶段报告的多学科团队与编写第 1 和第 2 阶段报告的团队相同。小组成员代表了大流行病期间医疗保健服务的领导专长和主要利益相关者(行政管理、感染控制、医生、护士、公共卫生、应急计划、灾难响应和信息技术)以及一名协调人。在第 3 阶段,小组采用结构化的头脑风暴法来确定各自组织应对大流行病的数字医疗的发现、问题和结果。此外,还对远程医疗资源中心(TRCs)组织确定的八家医疗服务提供者(医院)进行了访谈,这些医疗服务提供者使用了大流行应对计划(在第 1 和第 2 阶段创建)。所有访谈均由同一位主持人与八个项目的负责人(首席执行官和远程医疗项目负责人)进行,访谈中使用了团队制作的标准问卷。本报告引用了当前的文献资料,以说明研究结果是否具有更广泛的适用性。结论:COVID-19 大流行的影响十分严重,并发现了多个关键挑战和薄弱环节。事实证明,应用《大流行病应对行动计划》中概述的方法、工具和技术可有效解决医疗服务提供者面临的关键挑战。然而,在危机期间实施这些工具非常困难,除非组织事先对工具和必要的工作流程有经验。将这些工具作为标准工作流程和日常运作的一部分加以实施,提高了这些组织在此次大流行期间以及未来大流行期间提供医疗服务的能力和应变能力。
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Pandemic Action Plan: Phase 3-Lessons Learned from Implementation. "What Did We Learn?"

The COVID-19 pandemic created critical challenges for hospitals and health care providers. Suddenly clinics were forced to close; elective procedures were delayed; scheduled visits were canceled; emergency rooms were overcrowded; hospital beds, equipment, and personal protective equipment (PPE) were in short supply; and staff were faced with rapidly changing circumstances, care protocols, trauma, and personal risk. To better address challenges of the ongoing COVID-19 pandemic and prepare for future pandemics, the National Telemedicine Technology Assessment Resource Center (TTAC) was asked to develop a Pandemic Response Action Plan that would allow its users to address critical issues with available telemedicine and related technologies. The project was constructed in 3 phases. Phase 1-Develop a Pandemic Response Action Plan and a Pandemic Response Action Plan Policy and Regulatory Summary, which identifies the regulatory challenges as well as policy recommendations. Phase 2-Publish the Action Plan and the Policy and Regulatory Summary. Phase 3-Look at health care providers who used the approaches, tools, and technology in the Pandemic Action Plan and document the results. This document represents Phase 3. This document is Phase 3. In this report we look back at health care providers who used the approaches in the Phase 1 Pandemic Response Action Plan as published in Phase 2. In this document we report on the challenges and results of implementing parts of the Pandemic Action Plan. It records the findings, conclusions, and recommendations resulting from the experience of health care providers and the professional experiences of the team and their organizations in implementing parts or all of the plan. Methods: The same multidisciplinary team that constructed Phase 1 and Phase 2 were engaged to develop this Phase 3 report. The members of the team represent leadership expertise and key stakeholders in health care delivery during a pandemic (administration, infection control, physicians, nurses, public health, contingency planning, disaster response, and information technology) as well as a facilitator. For Phase 3, the group used structured brainstorming to define the findings, issues, and results of their own organizations' digital health response to the pandemic. In addition, eight health care providers (hospitals) identified by the Telemedicine Resource Centers' (TRCs) organizations, who used the Pandemic response Plan (created in Phases 1 and 2), were interviewed. All interviews were conducted by the same facilitator with leaders (CEO, and leaders of the telemedicine programs) in each of the eight programs, using a standard questionnaire created by the team. Current literature references are included in this report to illustrate when findings are known to have broader applicability. Conclusions: The impact of the COVID-19 Pandemic was severe and identified multiple critical challenges and weaknesses. Applying the approaches, tools, and technology outlined in the Pandemic Response Action Plan proved to be effective in addressing critical provider challenges. However, implementing these tools during a crisis was difficult unless the organization had experience with the tools and necessary workflows in advance. Implementing these tools as part of standard workflows and everyday operations increased the capabilities and resilience of these organizations in the provision of care during this and for future pandemics.

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来源期刊
Telemedicine and e-Health
Telemedicine and e-Health 医学-卫生保健
CiteScore
8.80
自引率
6.40%
发文量
270
审稿时长
2.3 months
期刊介绍: Telemedicine and e-Health is the leading peer-reviewed journal for cutting-edge telemedicine applications for achieving optimal patient care and outcomes. It places special emphasis on the impact of telemedicine on the quality, cost effectiveness, and access to healthcare. Telemedicine applications play an increasingly important role in health care. They offer indispensable tools for home healthcare, remote patient monitoring, and disease management, not only for rural health and battlefield care, but also for nursing home, assisted living facilities, and maritime and aviation settings. Telemedicine and e-Health offers timely coverage of the advances in technology that offer practitioners, medical centers, and hospitals new and innovative options for managing patient care, electronic records, and medical billing.
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