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为入住急性老年病科或急诊虚弱护理单元的老年人选择最适合的“患者相关结局”,并应用质量改进研究改善患者护理。

Selecting best-suited "patient-related outcomes" in older people admitted to an acute geriatric or emergency frailty unit and applying quality improvement research to improve patient care.

作者信息

Singh Inderpal, Aithal Shridhar

机构信息

Department of Geriatric Medicine, Ysbyty Ystrad Fawr, Aneurin Bevan University Health Board, Ystrad Mynach, UK,

出版信息

Patient Relat Outcome Meas. 2018 Sep 20;9:309-320. doi: 10.2147/PROM.S160519. eCollection 2018.

Abstract

The population is aging worldwide, and hospitals are admitting a higher proportion of acutely unwell older people. Population-specific factors such as multimorbidity and frailty in older people compounded by deficient expertise contribute to longer lengths of stay, higher readmission rates, and increased rates of institutionalization. A wide range of acute geriatric care models are currently providing acute care to frail older people and these have been shown to provide a cost-effective high-quality service. In this review, population-specific factors, service models, and a wide range of patient-related outcomes of "at risk" older people admitted to an acute geriatric care unit are explored. In addition, we also discuss data measurements and a quality improvement methodology to improve the delivery of care based on the patient outcome data. We hope, in addition to ensuring effectiveness and sustainability of our current services, this may also enhance academic research. Regular monitoring and evaluation of patient-related clinical outcomes not only improve the patient care and reduce the caregiver burden but also help in implementing quality initiatives to develop existing services.

摘要

全球人口正在老龄化,医院收治的急性病老年患者比例更高。老年人的多种疾病并存和身体虚弱等特定人群因素,再加上专业知识不足,导致住院时间延长、再入院率升高和机构化率增加。目前,多种急性老年护理模式正在为体弱的老年人提供急性护理,并且这些模式已被证明能提供具有成本效益的高质量服务。在本综述中,我们探讨了特定人群因素、服务模式以及入住急性老年护理病房的“高危”老年人的一系列与患者相关的结局。此外,我们还讨论了数据测量以及基于患者结局数据来改善护理服务的质量改进方法。我们希望,除了确保我们当前服务的有效性和可持续性之外,这还可能加强学术研究。定期监测和评估与患者相关的临床结局不仅能改善患者护理并减轻护理人员负担,还有助于实施质量改进措施以发展现有服务。

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