Hedges G, Grimmer K, Moss J, Falco J
Centre for Allied Health Research, University of South Australia, Adelaide, Australia.
Aust J Adv Nurs. 1999 Jun-Aug;16(4):20-8.
The literature on discharge planning was reviewed with the aim of developing performance indicators to complement the phases of successful discharge planning of: assessment of need, development of plans, implementation of plans and evaluation of outcome. The researchers suggest that these four phases link closely with steps in the Total Quality Management (TQM) cycle of thinking, planning, acting and reviewing. The literature review took account of stakeholders in discharge planning, defining them as hospital and community services, funding bodies and patients and carers. While the literature generally supports the need to develop discharge planning performance indicators, there were few concrete examples that reflected all phases of discharge planning or the needs of all stakeholders. The literature has focused largely on nursing discharge planning activities for specific patient groups, and/or particular hospital and community settings, and has commonly addressed only one or two phases of discharge planning. There were few articles that explored health outcome or cost savings derived from discharge planning on a large scale or over the longer term. The researchers conceptualised a notion of domains of quality discharge planning (efficiency of discharge planning process, timeliness of decision-making, stakeholder satisfaction and managing impediments to discharge), and propose performance indicators that address each discharge planning phase from the perspective of stakeholders.
对出院计划相关文献进行了综述,目的是制定绩效指标,以补充成功出院计划的各个阶段,即需求评估、计划制定、计划实施和结果评估。研究人员认为,这四个阶段与全面质量管理(TQM)的思考、计划、行动和审查循环步骤紧密相连。文献综述考虑了出院计划中的利益相关者,将其定义为医院和社区服务机构、资助机构以及患者和护理人员。虽然文献总体上支持制定出院计划绩效指标的必要性,但很少有具体实例能反映出院计划的所有阶段或所有利益相关者的需求。文献主要集中在针对特定患者群体、特定医院和社区环境的护理出院计划活动,并且通常只涉及出院计划的一两个阶段。很少有文章探讨大规模或长期出院计划所带来的健康结果或成本节约。研究人员构思了优质出院计划的领域概念(出院计划流程的效率、决策的及时性、利益相关者满意度以及消除出院障碍),并从利益相关者的角度提出了针对每个出院计划阶段的绩效指标。