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在复杂胃肠外科中构建共享护理模式:加拿大普通外科实践中队列和利益相关者的定性研究。

Mapping a shared care model in complex gastrointestinal surgery: A qualitative study of queues and stakeholders within a Canadian general surgery practice.

机构信息

University of Ottawa, Ottawa, Ontario, Canada.

University of Toronto, Toronto, Ontario, Canada.

出版信息

Healthc Manage Forum. 2023 Nov;36(6):399-404. doi: 10.1177/08404704231196816. Epub 2023 Aug 30.

Abstract

Shared Care Models (SCMs), in which a team of clinicians share in patient care and resource utilization, represent an opportunity for surgeon-level system change. We aimed to identify the queues and stakeholders within a complex gastrointestinal surgical care pathway to demonstrate the implications of a SCM on system efficiency. A multidisciplinary group of surgeons and care navigators working in SCMs were asked to develop a patient encounter map through consensus to illustrate relevant queues and stakeholders within a SCM. Fifteen surgeon-related queues were identified, each representing a point of potential delay to care in the patient's journey that could be addressed by shared care. A final patient encounter map was created, and advantages and challenges of SCMs were also described from multidisciplinary group discussions. The numerous queues identified in this map ultimately reflected opportunities for more efficient care navigation under a SCM through increased surgeon availability and shared resource utilization.

摘要

共担式照护模式(Shared Care Models,SCM)是指一组临床医生共同分担患者的医疗照护和资源利用,代表了外科医生层面进行系统变革的机会。我们旨在确定复杂胃肠外科护理路径中的队列和利益相关者,以展示 SCM 对系统效率的影响。一组从事 SCM 的多学科外科医生和护理导航员被要求通过共识制定患者就诊图,以说明 SCM 中的相关队列和利益相关者。确定了 15 个与外科医生相关的队列,每个队列都代表患者就诊过程中可能导致护理延迟的潜在点,这些延迟可以通过共担式照护来解决。最终创建了一个患者就诊图,并从多学科小组讨论中描述了 SCM 的优势和挑战。该地图中确定的众多队列最终反映了通过增加外科医生的可用性和共享资源利用,在 SCM 下进行更高效的护理导航的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7431/10604419/18d525879fc0/10.1177_08404704231196816-fig1.jpg

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