韩国老年友好型医院框架的制定：一项德尔菲研究。
Development of the Korean framework for senior-friendly hospitals: a Delphi study.
作者信息
Kim Yoon-Sook, Han Seol-Heui, Hwang Jeong-Hae, Park Jae-Min, Lee Jongmin, Choi Jaekyung, Moon Yeonsil, Kim Hee Joung, Shin Grace Jung Eun, Lee Ji-Sun, Choi Ye Ji, Uhm Kyeong Eun, Kim In Ae, Nam Ji-Won
机构信息
Department of Neurology, Konkuk University Medical Center, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, Korea.
Department of Health Administration, Hanyang Cyber University, 222 Wangsimri-ro, Seongdonggu, Seoul, 04763, Korea.
出版信息
BMC Health Serv Res. 2017 Aug 4;17(1):528. doi: 10.1186/s12913-017-2480-0.
BACKGROUND
Aging is an inevitable part of life. One can maintain well-being and wellness even after discharge and/or transition if his or her functional decline is minimized, sudden decline is prevented, and functioning is promoted during hospitalization. Caring appropriately for elderly patients requires the systematic application of Senior-Friendly Hospital principles to all operating systems, including medical centres' organization and environment, as well as patient treatment processes. The Senior-Friendly Hospital framework is valid and important for patient safety and quality improvement. This study aimed to make recommendations regarding the development of the Korean Framework for Senior-Friendly Hospitals for older patients' care management, patient safety interventions, and health promotion, via a Delphi survey.
METHODS
Two rounds of Delphi surveying were conducted with 15 participants who had at least 3 years' experience in accreditation surveying and medical accreditation standards, survey methods, and accreditation investigator education. In each round, we calculated statistics describing each standard's validity and feasibility.
RESULTS
The Korean Framework for Senior-Friendly Hospitals included 4 Chapters, 11 categories, and 67 standards through consensus of the Senior-Friendly Hospitals task force and experts' peer review. After the two rounds of Delphi surveying, validity evaluation led to no changes in standards of the Senior-Friendly Hospitals; however, the number of standards showing adequate validity decreased from 67 to 58. Regarding feasibility, no changes were necessary in the standards; however, the number of categories showing adequate feasibility decreased from 11 to 8 and from 67 to 30, respectively. The excluded categories were 3.2, 4.2, and 4.3 (service, transportation, and signage and identification). The highest feasibility values were given to standards 2.1.1, 4.1.4, and 4.1.6. The highest feasibility score was given to standard 2.4.2.
CONCLUSIONS
The Korean Framework for Senior-Friendly Hospitals needs to include 4 Chapters, 8 categories, and 30 standards. The Accreditation Program for Healthcare Organizations should include Senior-Friendly Hospitals -relevant standards considering Korea's medical environment.
背景
衰老是生命中不可避免的一部分。如果能够将功能衰退降至最低，防止突然衰退，并在住院期间促进功能恢复，那么即使在出院和/或转院后，人们也能够保持健康。妥善照顾老年患者需要将老年友好医院原则系统地应用于所有操作系统，包括医疗中心的组织和环境以及患者治疗过程。老年友好医院框架对于患者安全和质量提升是有效且重要的。本研究旨在通过德尔菲调查，就韩国老年友好医院框架的制定提出建议，以用于老年患者的护理管理、患者安全干预和健康促进。
方法
对15名在评审调查、医疗评审标准、调查方法和评审调查员教育方面至少有3年经验的参与者进行了两轮德尔菲调查。在每一轮中，我们计算了描述每个标准有效性和可行性的统计数据。
结果
通过老年友好医院工作组的共识和专家同行评审，韩国老年友好医院框架包括4章、11类和67项标准。经过两轮德尔菲调查，有效性评估导致老年友好医院的标准没有变化；然而，显示出足够有效性的标准数量从67项减少到了58项。关于可行性，标准无需更改；然而，显示出足够可行性的类别数量分别从11类减少到了8类，从67项减少到了30项。被排除的类别是3.2、4.2和4.3（服务、交通以及标识和识别）。可行性最高的值赋予了标准2.1.1、4.1.4和4.1.6。可行性得分最高的是标准2.4.2。
结论
韩国老年友好医院框架应包括4章、8类和30项标准。医疗组织评审计划应考虑韩国的医疗环境，纳入与老年友好医院相关的标准。
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