National Clinician Scholars Program, University of Michigan, Ann Arbor, Michigan, USA.
Division of Hospital Medicine, University of Michigan, Ann Arbor, Michigan, USA.
J Hosp Med. 2018 Dec 1;13(12):868-871. doi: 10.12788/jhm.3065. Epub 2018 Aug 29.
Many hospitalized patients have unmet palliative care needs that are exacerbated by gaps in the palliative care subspecialty workforce. Training frontline physicians, including hospitalists, to provide primary palliative care has been proposed as one solution to this problem. However, improving palliative care access requires more than development of the physician workforce. Systemlevel change and interdisciplinary approaches are also needed. Using task shifting as a guiding principle, we propose a new workforce framework (the Palliative care Redistribution Integrated System Model, or PRISM), which utilizes physician and nonphysician providers and resources to their maximum potential. We highlight the central role of hospitalists in this model and provide examples of innovations in screening, workflow, quality, and benchmarking to enable hospitalists to be purveyors of quality palliative care.
许多住院患者的姑息治疗需求未得到满足，而姑息治疗专业人员的短缺加剧了这一问题。培训包括医院医生在内的一线医生提供初级姑息治疗已被提议作为解决此问题的一种方法。然而，要改善姑息治疗的可及性，不仅需要发展医生队伍，还需要进行系统层面的改变和采取跨学科方法。我们以任务转移为指导原则，提出了一个新的劳动力框架（姑息治疗重新分配综合系统模型，或 PRISM），该框架利用医生和非医生提供者及资源，充分发挥其潜力。我们强调了医院医生在该模型中的核心作用，并提供了有关筛查、工作流程、质量和基准测试方面的创新示例，以使医院医生能够提供高质量的姑息治疗。
