Palchaudhuri Sonali, Mccreary Brigid, Davis Jessica, Mcginnis Brenna, Nyberg Susan, Mundi Manpreet S, Pham Angela
Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Curr Gastroenterol Rep. 2023 Mar;25(3):61-68. doi: 10.1007/s11894-023-00864-x. Epub 2023 Feb 3.
While the use of enteral nutrition (EN) has increased, and more medical centers have developed inpatient programs to address the unique needs of these patients, our collective experience at a few large institutions indicates that there is very little systemic support for patients after discharge. Here, we discuss what we have observed to be some of the barriers to providing outpatient follow up care, summarize the impact we have seen on patients, and propose some possible solutions.
We have observed and identified some of the root causes to include financial barriers; uncoordinated care transitions; high complexity of care, including medication management; and diffuse leadership to a multidisciplinary problem. Systematic support for outpatient care for patients discharged on enteral nutrition is rare and limited, due to many root causes. There are a few tools and tips that we have summarized here for individual providers, and a few promising methods in development, but a systematic approach is in great need.
虽然肠内营养(EN)的使用有所增加,且越来越多的医疗中心制定了住院治疗方案以满足这些患者的特殊需求,但我们几家大型机构的共同经验表明,患者出院后几乎没有系统性的支持。在此,我们讨论我们所观察到的提供门诊随访护理的一些障碍,总结我们所看到的对患者的影响,并提出一些可能的解决方案。
我们已经观察并确定了一些根本原因,包括经济障碍;护理过渡不协调;护理复杂性高,包括药物管理;以及对多学科问题的领导分散。由于多种根本原因,对肠内营养出院患者的门诊护理系统性支持很少且有限。我们在此为个体提供者总结了一些工具和提示,以及一些正在开发的有前景的方法,但非常需要一种系统性方法。