以“重要事项”指导出院后康复：在退伍军人事务部社区生活中心实施患者优先事项识别
Guiding Post-Hospital Recovery by 'What Matters:' Implementation of Patient Priorities Identification in a VA Community Living Center.
作者信息
Ritchey Katherine C, Solberg Laurence M, Citty Sandra Wolfe, Kiefer Lea, Martinez Erica, Gray Caroline, Naik Aanand D
机构信息
Puget Sound Veterans Health Care System, Geriatric Research and Education Clinical Center (GRECC), Tacoma, WA 98498, USA.
Division of Geriatrics and Gerontology, Department of Medicine, University of Washington, Seattle, WA 98109, USA.
出版信息
Geriatrics (Basel). 2023 Jul 4;8(4):74. doi: 10.3390/geriatrics8040074.
BACKGROUND
Patient priorities care (PPC) is an effective age-friendly health systems (AFHS) approach to aligning care with goals derived from 'what matters'. The purpose of this quality improvement program was to evaluate the fidelity and feasibility of the health priorities identification (HPI) process in VA Community Living Centers (CLC).
METHODS
PPC experts worked with local CLC staff to guide the integration of HPI into the CLC and utilized a Plan-Do-Study-Act (PDSA) model for this quality improvement project. PPC experts reviewed health priorities identification (HPI) encounters and interdisciplinary team (IDT) meetings for fidelity to the HPI process of PPC. Qualitative interviews with local CLC staff determined the appropriateness of the health priorities identification process in the CLC.
RESULTS
Over 8 months, nine facilitators completed twenty HPI encounters. Development of a Patient Health Priorities note template, staff education and PPC facilitator training improved fidelity and documentation of HPI encounters in the electronic health record. Facilitator interviews suggested that PPC is appropriate in this setting, not burdensome to staff and fostered a person-centered approach to AFHS.
CONCLUSIONS
The HPI process is an acceptable and feasible approach to ask the 'what matters' component of AFHS in a CLC setting.
背景
患者优先护理（PPC）是一种有效的关爱老年人的卫生系统（AFHS）方法，可使护理与源自“重要事项”的目标保持一致。本质量改进项目的目的是评估退伍军人事务部社区生活中心（CLC）中健康优先事项识别（HPI）流程的保真度和可行性。
方法
PPC专家与当地CLC工作人员合作，指导将HPI整合到CLC中，并在这个质量改进项目中采用了计划-实施-研究-改进（PDSA）模型。PPC专家审查了健康优先事项识别（HPI）会诊和跨学科团队（IDT）会议，以确保对PPC的HPI流程的保真度。对当地CLC工作人员进行的定性访谈确定了CLC中健康优先事项识别流程的适当性。
结果
在8个月的时间里，9名协调员完成了20次HPI会诊。患者健康优先事项记录模板的开发、工作人员教育和PPC协调员培训提高了电子健康记录中HPI会诊的保真度和记录。协调员访谈表明，PPC在这种情况下是合适的，对工作人员来说并不繁重，并促进了以患者为中心的AFHS方法。
结论
HPI流程是在CLC环境中询问AFHS的“重要事项”组成部分的一种可接受且可行的方法。
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