Jt Comm J Qual Patient Saf. 2023 Apr;49(4):213-222. doi: 10.1016/j.jcjq.2023.01.006. Epub 2023 Jan 14.
The rapid expansion and prompt widescale adoption of telehealth during the COVID-19 pandemic resulted in telehealth practice variations across health care settings and has implications for patient safety, health equity, and quality of care. Telehealth is part of the public health infrastructure, and health care stakeholders have an opportunity to strategically plan for telehealth expansion and sustainability in organizations as the pandemic wanes. A framework to guide organizational telehealth integration is needed that can support safe, accessible, and high-quality telehealth to patients regardless of social and/or economic status. The purpose of this article is to propose an innovative telehealth model, supported by systems theory, to address the complexity of telehealth implementation in health care organizations. A Donabedian approach is used to address quality. The telehealth model is an organizational infrastructure that outlines how policy and authority requirements, organization factors, provider competencies, and patient determinants of health influence safer, more equitable, higher-quality telehealth. The framework can guide leaders in building, redesigning, and measuring the impact of telehealth programs as health care shifts into a revolutionary technology era to meet the needs of diverse organizations and populations.
在 COVID-19 大流行期间，远程医疗迅速扩张并广泛采用，导致医疗保健环境中的远程医疗实践存在差异，这对患者安全、医疗公平和护理质量都有影响。远程医疗是公共卫生基础设施的一部分，随着大流行的减弱，医疗保健利益相关者有机会在组织中战略性地规划远程医疗的扩展和可持续性。需要一个框架来指导组织的远程医疗整合，该框架可以支持为患者提供安全、可及和高质量的远程医疗，无论其社会和/或经济地位如何。本文旨在提出一种创新的远程医疗模式，该模式以系统理论为支撑，以解决医疗保健组织中远程医疗实施的复杂性。采用 Donabedian 方法来解决质量问题。远程医疗模式是一种组织基础设施，概述了政策和权限要求、组织因素、提供者能力以及患者健康决定因素如何影响更安全、更公平、更高质量的远程医疗。该框架可以指导领导者构建、重新设计和衡量远程医疗计划的影响，因为医疗保健进入了一个革命性的技术时代，以满足不同组织和人群的需求。
