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一项实施协同工具并评估其对长期护理居民影响的混合方法研究。

A Mixed Methods Study to Implement the Synergy Tool and Evaluate Its Impact on Long-Term Care Residents.

作者信息

Havaei Farinaz, Kobekyaa Francis, Ma Andy, MacPhee Maura, Zhang Wei, Kaulius Megan, Ahmadi Bahar, Boamah Sheila, Easterbrook Adam, Salmon Amy

机构信息

School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada.

Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.

出版信息

Healthcare (Basel). 2023 Aug 2;11(15):2187. doi: 10.3390/healthcare11152187.

Abstract

BACKGROUND

There are ongoing workforce challenges with the delivery of long-term care (LTC), such as staffing decisions based on arbitrary standards. The Synergy tool, a resident-centered approach to staffing, provides objective, real-time acuity and dependency scores (Synergy scores) for residents. The purpose of this study was to implement and evaluate the impact of the Synergy tool on LTC delivery.

METHODS

A longitudinal mixed methods study took place within two publicly funded LTC homes in British Columbia, Canada. Quantitative data included weekly Synergy scores for residents (24 weeks), monthly aggregated resident falls data (18 months) and a six-month economic evaluation. Qualitative data were gathered from family caregivers and thematically analyzed.

RESULTS

Quantitative findings from Synergy scores revealed considerable variability for resident acuity/dependency needs within and across units; and falls decreased during implementation. The six-month economic evaluation demonstrated some cost savings by comparing Synergy tool training and implementation costs with savings from resident fall rate reductions. Qualitative analyses yielded three positive impact themes (, , and ), and two negative structural themes ( and ).

CONCLUSIONS

The Synergy tool provides useful data for enhancing a 'fit' between resident needs and available staff.

摘要

背景

长期护理(LTC)服务的提供面临持续的劳动力挑战,例如基于任意标准做出人员配置决策。协同工具是一种以居民为中心的人员配置方法,可为居民提供客观、实时的 acuity 和依赖度评分(协同评分)。本研究的目的是实施并评估协同工具对长期护理服务提供的影响。

方法

在加拿大不列颠哥伦比亚省的两家公立长期护理机构中开展了一项纵向混合方法研究。定量数据包括居民的每周协同评分(24周)、每月汇总的居民跌倒数据(18个月)以及为期六个月的经济评估。从家庭护理人员那里收集定性数据并进行主题分析。

结果

协同评分的定量结果显示,各单元内部和之间居民的 acuity/依赖度需求存在很大差异;在实施过程中跌倒次数减少。为期六个月的经济评估表明,通过将协同工具培训和实施成本与居民跌倒率降低所节省的成本进行比较,实现了一些成本节约。定性分析产生了三个积极影响主题(、和),以及两个消极结构主题(和)。

结论

协同工具为增强居民需求与现有工作人员之间的“匹配度”提供了有用的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6698/10418466/69e47ee7a31d/healthcare-11-02187-g001.jpg

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