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从利益相关者的角度评估一项旨在避免澳大利亚塔斯马尼亚州患者住院的新型职业治疗服务扩展范围。

Evaluating a Novel Extended Scope of Occupational Therapy Service Aimed at Hospital Avoidance in Tasmania, Australia, from the Perspective of Stakeholders.

作者信息

Van Dam Pieter Jan, Reid Leah, Elliott Sarah, Dwyer Mitchell

机构信息

School of Nursing, College of Health and Medicine, University of Tasmania, 4-8 Bass Hwy, Burnie, TAS 7320, Australia.

Royal Hobart Hospital, Tasmanian Health Service, 48 Liverpool St., Hobart, TAS 7000, Australia.

出版信息

Healthcare (Basel). 2022 May 3;10(5):842. doi: 10.3390/healthcare10050842.

Abstract

The Australian state of Tasmania has seen a spike in Emergency Department presentations in recent years, particularly among the elderly. A novel extended scope occupational therapy (ESOT) service was implemented by the Tasmanian Health Service, aimed at supporting hospital avoidance. Clients were referred to the ESOT service by other services after being assessed as having a high risk of imminent hospital presentation. Occupational Therapists provided short-term interventions related to falls, mobility, nutrition, and initiated onward referrals to other services. A convergent parallel mixed methods design was used to evaluate the ESOT service. Quantitative data from routinely collected administrative records and a purpose-built survey of referring clinicians were used alongside qualitative data from semi-structured interviews with clients/carers, to enable the triangulation of data. Quantitative data were analysed using descriptive statistics, while qualitative data collected in interviews were thematically analysed. A total of 104 extended scope interventions were provided to 100 clients. Most clients were able to stay at home. Qualitative data revealed that mobility, support, and facilitating access to support services were factors which added value to the client and carer experience. In conclusion, the ESOT program contributed to potentially avoiding hospital admissions and to improving the quality of life of participating clients.

摘要

近年来,澳大利亚塔斯马尼亚州急诊科的就诊人数激增,尤其是在老年人中。塔斯马尼亚州卫生服务部门实施了一项新型的扩展范围职业治疗(ESOT)服务,旨在帮助避免患者住院。在被评估为近期有很高的住院风险后,患者由其他服务机构转介至ESOT服务。职业治疗师提供了与跌倒、行动能力、营养相关的短期干预措施,并开始将患者进一步转介至其他服务机构。采用了一种收敛平行混合方法设计来评估ESOT服务。来自常规收集的行政记录的定量数据以及对转诊临床医生的专门调查,与来自对患者/护理人员的半结构化访谈的定性数据一起使用,以便对数据进行三角测量。定量数据使用描述性统计进行分析,而访谈中收集的定性数据则进行主题分析。总共为100名患者提供了104项扩展范围的干预措施。大多数患者能够居家。定性数据显示,行动能力、支持以及便利获得支持服务是为患者和护理人员的体验增添价值的因素。总之,ESOT项目有助于潜在地避免患者住院,并提高参与项目患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1da/9140654/3328841f9141/healthcare-10-00842-g001.jpg

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