Wasson John H, Godfrey Marjorie M, Nelson Eugene C, Mohr Julie J, Batalden Paul B
Dartmouth Medical School, Hanover, New Hampshire, USA.
Jt Comm J Qual Saf. 2003 May;29(5):227-37. doi: 10.1016/s1549-3741(03)29027-4.
Clinical microsystems are the essential building blocks of all health systems. At the heart of an effective microsystem is a productive interaction between an informed, activated patient and a prepared, proactive practice staff. Support, which increases the patient's ability for self-management, is an essential result of a productive interaction. This series on high-performing clinical microsystems is based on interviews and site visits to 20 clinical microsystems in the United States. This fourth article in the series describes how high-performing microsystems design and plan patient-centered care. PLANNING PATIENT-CENTERED CARE: Well-planned, patient-centered care results in improved practice efficiency and better patient outcomes. However, planning this care is not an easy task. Excellent planned care requires that the microsystem have services that match what really matters to a patient and family and protected time to reflect and plan. Patient self-management support, clinical decision support, delivery system design, and clinical information systems must be planned to be effective, timely, and efficient for each individual patient and for all patients.
Excellent planned services and planned care are attainable today in microsystems that understand what really matters to a patient and family and have the capacity to provide services to meet the patient's needs.
临床微系统是所有卫生系统的基本组成部分。有效微系统的核心是明智、积极的患者与有准备、积极主动的医疗团队之间富有成效的互动。支持可增强患者的自我管理能力,是富有成效的互动的重要成果。本系列关于高效临床微系统的文章基于对美国20个临床微系统的访谈和实地考察。本系列的第四篇文章描述了高效微系统如何设计和规划以患者为中心的护理。
精心规划、以患者为中心的护理可提高医疗效率并改善患者预后。然而,规划这种护理并非易事。出色的规划护理要求微系统具备与患者及其家人真正关心的事项相匹配的服务,以及用于反思和规划的受保护时间。必须针对每位患者及所有患者,规划有效的、及时的和高效的患者自我管理支持、临床决策支持、服务提供系统设计以及临床信息系统。
如今,在了解患者及其家人真正关心的事项并具备提供满足患者需求的服务能力的微系统中,出色的规划服务和规划护理是可以实现的。