Bynum Debra L, Wilson Lindsay A, Ong Thuan, Callahan Kathryn E, Dalton Thomas, Ohuabunwa Ugochi
Division of Geriatric Medicine, Center for Aging and Health, University of North Carolina, Chapel Hill, North Carolina.
Division of Gerontology and Geriatric Medicine, University of Washington Harborview Medical Center, Seattle, Washington.
J Am Geriatr Soc. 2015 Sep;63(9):1918-23. doi: 10.1111/jgs.13598. Epub 2015 Aug 27.
In order to determine how often internal medicine and family medicine residents performed specific actions related to the geriatric competencies established by the American Geriatrics Society (AGS) when caring for older hospitalized adults, a cross-sectional anonymous survey of residents at the University of North Carolina, University of Washington, Wake Forest University, Duke University, and Emory University was undertaken. Data on frequency of self-reported behaviors were analyzed, with comparisons made for different levels of training, institution, and program. A total of 375 residents responded for an overall response rate of 48%. Residents reported that they often do not demonstrate all of the AGS recommended core competencies when caring for older adults in the hospital setting. Residents report more frequently performing activities that are routinely integrated into hospital systems such as reviewing medication lists, working with an interdisciplinary team, evaluating for inappropriate bladder catheters, and evaluating for pressure ulcers. There were no consistent differences between institutions and only minor differences noted between Family Medicine and Internal Medicine residents. Operationalizing core competencies by integrating them into hospital systems' quality process indicators may prompt more consistent high-quality care and ensure systems support residents' competence.
为了确定内科和家庭医学住院医师在照顾老年住院患者时执行与美国老年医学会（AGS）制定的老年医学能力相关的特定行为的频率，对北卡罗来纳大学、华盛顿大学、维克森林大学、杜克大学和埃默里大学的住院医师进行了一项横断面匿名调查。分析了自我报告行为的频率数据，并对不同培训水平、机构和项目进行了比较。共有375名住院医师做出回应，总体回应率为48%。住院医师报告称，在医院环境中照顾老年人时，他们常常无法展现出AGS推荐的所有核心能力。住院医师报告称，他们更频繁地开展一些常规融入医院系统的活动，如审查用药清单、与跨学科团队合作、评估不当使用膀胱导管情况以及评估压疮情况。各机构之间没有一致的差异，家庭医学和内科住院医师之间仅存在细微差异。将核心能力纳入医院系统的质量过程指标来实施，可能会促使提供更一致的高质量护理，并确保系统支持住院医师的能力。
