Alzheimer's Association, 5900 Wilshire Blvd., Los Angeles, CA 90036, U.S.A.
Int Psychogeriatr. 2009 Apr;21 Suppl 1:S44-52. doi: 10.1017/S1041610209008692. Epub 2009 Mar 17.
This paper presents a strategy for training primary care physicians in the identification, diagnosis and management of Alzheimer's disease and related disorders. The strategy uses evidence-based practice guidelines to establish quality benchmarks and then provides training and other interventions to improve the quality of care received by these patients. The three projects described in this paper assumed that training of primary care physicians alone would not be sufficient to achieve the quality benchmarks derived from guidelines. The projects used creative training strategies supplemented by provider "tool kits", provider checklists, educational detailing, and endorsement from organizational leadership to reinforce what the primary care providers learned in educational sessions. Each project also implemented a system of dementia care management to "wrap around" traditional primary care to ensure that quality benchmarks would be achieved. Outcomes of two completed studies support the premise that it is possible to improve quality of dementia care through physician education that occurs in association with a coordinated system of dementia care management and in collaboration with community agencies to access guideline-recommended social services.
本文提出了一种培训初级保健医生识别、诊断和管理阿尔茨海默病及相关疾病的策略。该策略使用循证实践指南来建立质量基准,然后提供培训和其他干预措施,以提高这些患者的护理质量。本文所述的三个项目假设,仅对初级保健医生进行培训是不足以达到指南衍生出的质量基准的。这些项目使用了创造性的培训策略,辅以提供方“工具包”、提供方清单、教育细节以及组织领导层的认可,以强化初级保健提供者在教育课程中所学到的知识。每个项目还实施了痴呆症护理管理系统,以“围绕”传统的初级保健,确保实现质量基准。两项已完成研究的结果支持这样一个前提,即通过与协调的痴呆症护理管理系统以及与社区机构合作以获得指南推荐的社会服务相关联的医生教育,可以改善痴呆症护理质量。