Department of Internal Medicine and Gastroenterology, University Hospital Bucharest, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Internal Medicine, Infectious Diseases and Respiratory Medicine, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
Eur J Intern Med. 2019 Mar;61:44-47. doi: 10.1016/j.ejim.2018.10.017. Epub 2018 Nov 15.
With the increase of ageing population, rates of chronic diseases and complex medical conditions, the management of high-risk surgical patients is likely to become a great concern in most countries. Considering all these factors, it is certainly rational and intuitive that internists should be included into a collaborative model of medical and surgical co-management, where their multi-potentiality and synthesis capacity require them to coordinate the multidisciplinary team and to be the leading agent of change. In this regard, our aim was to present the official position and approach of the Working Group on Professional Issues and Quality of Care of the European Federation of Internal Medicine (EFIM), for implementation of this strategy of care, encouraging internists to assume an important role and to provide continuity of multidisciplinary care, from the decision to operate through to rehabilitation and recovery. Moving from the traditional model of medical care of the surgical patients to the co-management model, from a reactive simple consultation to a new pro-active continued service, may optimize the quality and perioperative care, improving the survival, shortening hospital stays, replacing the old strategy of late and complication treatment to an early and preventive one.
随着人口老龄化、慢性病和复杂医疗状况发生率的增加，高风险手术患者的管理在大多数国家都可能成为一个重大关注点。考虑到所有这些因素，内科医生被纳入医疗和手术联合管理的协作模式是合理且直观的，因为他们的多能性和综合能力要求他们协调多学科团队，并成为变革的主导力量。在这方面，我们的目的是介绍欧洲内科学联合会（EFIM）专业问题和护理质量工作组的官方立场和方法，以实施这一护理策略，鼓励内科医生发挥重要作用，并提供从决定手术到康复和恢复的多学科护理的连续性。从外科患者的传统医疗模式转变为联合管理模式，从被动的简单咨询转变为新的主动持续服务，可能会优化质量和围手术期护理，提高生存率，缩短住院时间，用早期和预防性策略取代旧的晚期和并发症治疗策略。
