Worcester M, Pesznecker B, Albert M, Grupp K, Horn B, O'Connor K
School of Nursing, University of Washington, Seattle 98195.
Home Health Care Serv Q. 1991;12(2):53-169. doi: 10.1300/J027v12n02_05.
Clear and concise written guidelines must designate accountability for coordination of the persons involved. As might be assumed by the preceding discussion, the process takes considerable time and effort. The development of clear guidelines is a long term venture and usually does not occur quickly. In some cases a nearby agency may have developed a useful protocol that when shared with area providers, is quickly accepted. However, one to two years is not uncommon to developing a complex plan of care or protocol which can be used effectively and is specific to the conditions in a particular setting. Written guides, when developed correctly, should save all providers' time, and ensure better client care. Clear directions regarding the care to be provided and well-established lines of communication can save health care providers time and increase the likelihood of better health outcomes for the client. The coordination of planning within the home care agency, and across professional, agency and geographic boundaries is a prerequisite for successful cancer symptom management. The central aim in planning is to enhance the family's ability to manage independently and to facilitate continuity of care in the use of health care services. For the client to have the greatest potential for symptom amelioration, the home care agency must assume a major role in the coordination of care providers in the delivery of care.
清晰简洁的书面指南必须明确参与人员协调工作的责任。正如前文讨论可能会让人想到的那样，这个过程需要耗费大量的时间和精力。制定清晰的指南是一项长期工作，通常不会很快完成。在某些情况下，附近的机构可能已经制定了一份有用的方案，与当地的服务提供者分享后，会很快被接受。然而，制定一个能有效使用且针对特定环境条件的复杂护理计划或方案，一到两年的时间并不罕见。正确制定的书面指南应该能节省所有服务提供者的时间，并确保为客户提供更好的护理。关于所提供护理的明确指示以及完善的沟通渠道，可以节省医疗服务提供者的时间，并增加客户获得更好健康结果的可能性。家庭护理机构内部以及跨专业、机构和地域界限的规划协调，是成功进行癌症症状管理的先决条件。规划的核心目标是增强家庭独立管理的能力，并促进在使用医疗服务时护理的连续性。为了使客户有最大的症状改善潜力，家庭护理机构必须在协调护理提供者提供护理方面发挥主要作用。
