O'Neal Mary A, Zecavati Nassim, Yu Melissa, Spain Rebecca, Friedenberg Scott M, El Husseini Nada, Torres-Russotto Diego R, Feliciano Briseida, Spears Roderick, Baca Christine
From the Brigham and Women's Hospital (M.A.O.N.), Boston, MA; Children's Hospital of Richmond (N.Z.), Richmond, VA; Baylor College of Medicine (M.Y.), Houston, TX; Oregon Health Sciences University (Rebecca Spain), Portland, OR; Geisinger Medical Center (S.M.F.), Danville, PA; Duke University Medical Center (N.E.H.), Durham, NC; University of Nebraska Medical Center (D.R.T.-R.), Omaha, NE; None (B.F.); University of Pennsylvania (Roderick Spears), Philadelphia, PA; and University of Colorado Medical Center (C.B.), Denver, CO.
Neurology. 2022 Jan 24;98(4):146-153. doi: 10.1212/WNL.0000000000013079.
To define fragmentation in neurologic care delivery, explain the positive and negative drivers in neurologic practice that contribute to fragmentation, illustrate situations that increase fragmentation risk, emphasize the costs and impact on both patients and providers, and propose solutions that allow for more cohesive care.
The Transforming Leaders Program (TLP) class of 2020 was tasked by American Academy of Neurology (AAN) leadership to identify the leading trends in inpatient and outpatient neurology and to predict their effects on future neurologic practice.
Research material included AAN databases, PubMed searches, discussion with topic experts, and AAN leadership.
Trends in care delivery are driven by changes in the work force, shifts in health care delivery, care costs, changes in evidence-based care, and patient factors. These trends can contribute to care fragmentation. Potential solutions to these problems are proposed based on care models developed in oncology and medicine.
This article shares our opinions as there is a lack of evidence-based guidelines for optimal neurologic care delivery.
定义神经科护理服务中的碎片化现象，解释神经科实践中导致碎片化的积极和消极驱动因素，举例说明增加碎片化风险的情况，强调成本以及对患者和医疗服务提供者的影响，并提出实现更连贯护理的解决方案。
美国神经病学学会（AAN）领导层要求2020年转型领导者计划（TLP）班级确定住院和门诊神经病学的主要趋势，并预测它们对未来神经科实践的影响。
研究材料包括AAN数据库、PubMed检索、与主题专家的讨论以及AAN领导层。
护理服务趋势受到劳动力变化、医疗服务提供方式转变、护理成本、循证护理变化以及患者因素的驱动。这些趋势可能导致护理碎片化。基于肿瘤学和医学中开发的护理模式，针对这些问题提出了潜在的解决方案。
由于缺乏关于最佳神经科护理服务的循证指南，本文分享的是我们的观点。
