评估病人出院准备情况、出院沟通和过渡护理管理。

IF 2.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI:10.3122/jabfm.2023.230172R3
Catherine E Elmore, Mackenzie Elliott, Kirsten E Schmutz, Sonja E Raaum, Erin Phinney Johnson, Alycia A Bristol, Molly B Conroy, Andrea S Wallace
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引用次数: 0

摘要

背景:住院医生和初级保健临床医生之间的出院沟通对于改善护理协调、最大限度地减少不良事件以及减少计划外医疗服务的使用至关重要。与健康相关的社会需求是健康的主要驱动力,住院医生和初级保健临床医生重视出院时的社会需求沟通:目的:1)描述学术医疗中心医院与相关诊所的初级保健临床医生之间的出院沟通现状;2)就出院准备信息对初级保健临床医生的潜在有用性寻求反馈:设计:探索性、收敛性混合方法:参与者:美国西部山间学术医疗中心家庭医学科和普通内科的初级保健临床医生:方法:文献信息 REDCap 调查。与关键信息提供者共同制定以当前文献为基础的半结构式访谈指南。对调查数据进行描述性总结;对访谈数据进行演绎和归纳编码,并按主题进行组织:结果:出现了两个关键主题:1)出院沟通,包括过渡性护理管理和后续预约挑战等相互关联的主题,以及改善出院沟通的建议;2)出院准备信息的有用性,包括对不同环境中的角色和责任缺乏共同理解等相互关联的主题,以及与发现可能无法解决的问题相关的伦理问题:本研究在重申长期存在的出院沟通和过渡护理管理挑战的同时,还揭示了这些问题与评估和应对患者出院准备不足以及护理过渡期间未满足的社会需求之间的相互关系。初级保健临床医生对出院准备信息的有用性看法不一。我们提出了改善出院沟通和过渡护理管理 (TCM) 流程的建议,这些建议可能适用于其他护理环境。
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Assessing Patient Readiness for Hospital Discharge, Discharge Communication, and Transitional Care Management.

Background: Discharge communication between hospitalists and primary care clinicians is essential to improve care coordination, minimize adverse events, and decrease unplanned health services use. Health-related social needs are key drivers of health, and hospitalists and primary care clinicians value communicating social needs at discharge.

Objective: To 1) characterize the current state of discharge communications between an academic medical center hospital and primary care clinicians at associated clinics; 2) seek feedback about the potential usefulness of discharge readiness information to primary care clinicians.

Design: Exploratory, convergent mixed methods.

Participants: Primary care clinicians from Family Medicine and General Internal Medicine of an academic medical center in the US Intermountain West.

Approach: Literature-informed REDCap survey. Semistructured interview guide developed with key informants, grounded in current literature. Survey data were descriptively summarized; interview data were deductively and inductively coded, organized by topics.

Results: Two key topics emerged: 1) discharge communication, with interrelated topics of transitional care management and follow-up appointment challenges, and recommendations for improving discharge communication; and 2) usefulness of the discharge readiness information, included interrelated topics related to lack of shared understanding about roles and responsibilities across settings and ethical concerns related to identifying problems that may not have solutions.

Conclusions: While reiterating perennial discharge communication and transitional care management challenges, this study reveals new evidence about how these issues are interrelated with assessing and responding to patients' lack of readiness for discharge and unmet social needs during care transitions. Primary care clinicians had mixed views on the usefulness of discharge readiness information. We offer recommendations for improving discharge communication and transitional care management (TCM) processes, which may be applicable in other care settings.

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来源期刊
CiteScore
4.90
自引率
6.90%
发文量
168
审稿时长
4-8 weeks
期刊介绍: Published since 1988, the Journal of the American Board of Family Medicine ( JABFM ) is the official peer-reviewed journal of the American Board of Family Medicine (ABFM). Believing that the public and scientific communities are best served by open access to information, JABFM makes its articles available free of charge and without registration at www.jabfm.org. JABFM is indexed by Medline, Index Medicus, and other services.
期刊最新文献
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