从高价值医疗保健出发：支持高价值医疗保健的内容、交付、衡量和维持的范围审查和工具包。
Beginning with high value care in mind: A scoping review and toolkit to support the content, delivery, measurement, and sustainment of high value care.
机构信息
Reaching for High Value Care Team, Chapel Hill, NC, USA.
Reaching for High Value Care Team, Chapel Hill, NC, USA; Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family and Community Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Patient Educ Couns. 2019 Feb;102(2):238-252. doi: 10.1016/j.pec.2018.05.014. Epub 2018 May 20.
OBJECTIVE
To create a shared vision for the content, delivery, measurement, and sustainment of patient-centered high value care.
METHODS
We performed a scoping review and translated findings into toolkit for system leaders. For our scoping review, we searched Medline, 2005-November 2015, for literature on patient-centered care (PCC) and its relationship to a high value care change model. We supplemented searches with key author, Google Scholar, and key website searches. One author reviewed all titles, abstracts, and articles for inclusion; another reviewed a random 20%. To develop our toolkit, we translated evidence into simple, actionable briefs on key topics and added resources. We then iteratively circulated briefs and the overall toolkit to potential users, making updates as needed.
RESULTS
In our scoping review, we found multiple interventions and measures to support the components of PCC and our change model. We found little on the overall effects of PCC or how PCC creates value. Potential users reported our toolkit was simple, understandable, thorough, timely, and likely to be globally useful.
CONCLUSIONS
Considerable evidence supports patient-centered high value care and a toolkit garnered enthusiasm.
PRACTICE IMPLICATIONS
The toolkit is ready for use, but needs comparison to other approaches.
目的
为以患者为中心的高价值医疗照护的内容、传递、衡量和维持创建共同愿景。
方法
我们进行了范围界定审查，并将结果转化为系统领导者工具包。我们在 Medline 上搜索了 2005 年至 2015 年 11 月的关于以患者为中心的医疗照护（PCC）及其与高价值医疗照护变革模式关系的文献。我们还通过主要作者、谷歌学术和主要网站搜索补充了搜索。一位作者审查了所有标题、摘要和文章，以确定是否纳入；另一位作者随机审查了 20%的文章。为了开发我们的工具包，我们将证据转化为关于关键主题的简单、可操作的简介，并添加了资源。然后，我们将简介和整体工具包循环分发给潜在用户，并根据需要进行更新。
结果
在我们的范围界定审查中，我们发现了多项干预措施和措施来支持 PCC 和我们的变革模式的组成部分。我们发现关于 PCC 的整体效果或 PCC 如何创造价值的信息很少。潜在用户报告说，我们的工具包简单易懂、全面及时，可能在全球范围内有用。
结论
大量证据支持以患者为中心的高价值医疗照护，且工具包受到了欢迎。
实践意义
该工具包已准备好使用，但需要与其他方法进行比较。
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