Foulds Jessica L, Forbes Karen L
Division of Pediatric Hospital Medicine, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
Paediatr Child Health. 2019 Nov 19;25(7):409-413. doi: 10.1093/pch/pxz146. eCollection 2020 Nov.
The American College of Physicians defines high-value care (HVC) as health care that balances clinical benefit with costs and harms with the goal of improving patient outcomes. We present a novel 2-hour workshop developed for general paediatric residents designed to promote reflective practice on resource stewardship and raise awareness of costs of medical care in hospitalized children. The workshop impact was assessed quantitatively and qualitatively. Preworkshop, 2-week postworkshop, and 6-month postworkshop electronic surveys were completed by 18 of 43 workshop participants (42% survey participation rate, 100% follow-up in postworkshop surveys) revealing increased knowledge and retention. Thematic analysis performed on 'lessons learned' and 'action plans' provided by participants at the end of the workshop yielded rich data with key findings from learners that included critical thinking about their management and reflecting on nonmonetary costs. Future directions include faculty development and assessment of impact on patient care.
美国医师学会将高价值医疗（HVC）定义为一种医疗保健模式，它在临床效益与成本、危害之间寻求平衡，旨在改善患者治疗效果。我们为普通儿科住院医师开发了一个全新的两小时工作坊，旨在促进对资源管理的反思性实践，并提高对住院儿童医疗成本的认识。对该工作坊的影响进行了定量和定性评估。43名工作坊参与者中有18人完成了工作坊前、工作坊后两周和工作坊后六个月的电子调查（调查参与率为42%，工作坊后调查的随访率为100%），结果显示知识有所增加且得以保留。对参与者在工作坊结束时提供的“经验教训”和“行动计划”进行的主题分析产生了丰富的数据，学习者的关键发现包括对其管理的批判性思考以及对非货币成本的反思。未来的方向包括教师发展以及对患者护理影响的评估。
