Brown Cara L, Menec Verena
Department of Occupational Therapy, Rady Faculty of Health Sciences, University of Manitoba, R106 - 771 McDermot Avenue, University of Manitoba, Winnipeg, MB R3E 0T6, Canada.
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, S111-750 Bannatyne Avenue, University of Manitoba, Winnipeg, MB R3E 0W3, Canada.
Int J Integr Care. 2021 Apr 26;21(2):12. doi: 10.5334/ijic.5552.
Integrated care is a promising approach to improve transitions from hospital for older adults. Measures of integrated care tend to be survey-based or outcomes focused. This study determined the feasibility of using hospital chart data to measure integrated processes of care.
This paper reports on two objectives: 1) the development of an integrated care transition framework and associated features of care; 2) a pilot study to test if the features could be applied to 214 hospital patient charts.
Twenty-four features were tested, and fifteen features could be reliably measured using chart review. Of these, the percent of patients classified as receiving integrated care varied widely across the items, from 0.05% to 84.1%.
The framework presented in this paper can guide measurement of system and clinical delivery of integrated care transitions. In combination with other tools, chart review can provide perspective on day-to-day care delivery not otherwise accessible, and highlight areas requiring practice change.
Multiple measurement perspectives are needed to improve our understanding of how integrated care is being implemented. While chart review cannot address the full breadth of integrated care, it can help understand how processes of care are being implemented in routine daily care.
综合护理是改善老年人出院过渡的一种有前景的方法。综合护理的衡量指标往往基于调查或聚焦于结果。本研究确定了使用医院病历数据来衡量综合护理过程的可行性。
本文报告了两个目标：1）开发一个综合护理过渡框架及相关护理特征；2）进行一项试点研究，以测试这些特征是否可应用于214份医院患者病历。
对24个特征进行了测试，其中15个特征可通过病历审查可靠地测量。在这些特征中，被归类为接受综合护理的患者百分比在各个项目中差异很大，从0.05%到84.1%不等。
本文提出的框架可指导综合护理过渡的系统和临床实施的测量。与其他工具相结合，病历审查可以提供关于日常护理提供情况的视角，而这是通过其他方式无法获得的，并突出需要改变实践的领域。
需要多种测量视角来增进我们对综合护理实施方式的理解。虽然病历审查无法涵盖综合护理的全部范围，但它有助于了解日常常规护理中护理过程是如何实施的。
