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在住院康复中实施实时患者体验反馈:基于常规过程理论的过程评估。

Implementing a real-time patient experience feedback in inpatient rehabilitation: Process evaluation informed by the normalisation process theory.

机构信息

Shirley Ryan AbilityLab, Chicago, Illinois, USA.

Division of Occupational Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA.

出版信息

Int J Health Plann Manage. 2024 Nov;39(6):1737-1754. doi: 10.1002/hpm.3832. Epub 2024 Aug 2.

Abstract

PURPOSE

Near real-time patient experience feedback (NRTPEF) can enable a patient-centric, immediate service recovery but has not been widely used in inpatient rehabilitation. We 1) assess the utility, feasibility, and acceptability of implementing a new NRTPEF, perceived by patients and providers; and 2) understand how the NRTPEF became embedded into routine provider practices.

MATERIALS AND METHODS

Mixed methods process evaluation of the 8-month implementation of an innovative NRTPEF in an inpatient rehabilitation unit, using interviews and focus groups with all the service-unit leaders and interviews with a randomised sample of patients. Beyond descriptive statistics and content analysis, the Normalisation Process Theory (NPT) informed a framework analysis.

RESULTS

Patients and service-unit leaders perceived high utility in the NRTPEF (median: 9 for both; 0-10 scale) and qualitative comments emphasised the value of providing/obtaining timely feedback. The system was found feasible and acceptable for patients (median: 9.5), but with an improvement margin for providers (median: 7.3). Suggestions include strengthening the data-relay format. Even in the pilot form, providers found the NRTPEF became embedded into practice (median 10; average: 8.6). The analysis based on the NPT shows how providers saw differential value, engaged with, and used the patient feedback into reconfigured practices.

CONCLUSION

An innovative NRTPEF was found useful, feasible and acceptable, but with refinement opportunities before scale-up.

摘要

目的

即时患者体验反馈(NRTPEF)可以实现以患者为中心的即时服务补救,但尚未在住院康复中广泛应用。我们 1)评估患者和提供者感知到的新即时患者体验反馈的实用性、可行性和可接受性;2)了解即时患者体验反馈如何融入常规提供者实践。

材料与方法

对住院康复病房实施创新即时患者体验反馈的 8 个月混合方法过程评估,使用对所有服务单元领导的访谈和焦点小组,以及对随机抽取的患者的访谈。除了描述性统计和内容分析外,规范进程理论(NPT)还为框架分析提供了信息。

结果

患者和服务单元领导认为即时患者体验反馈具有很高的实用性(中位数:9;0-10 分制),定性评论强调了提供/获得及时反馈的价值。该系统对患者来说是可行且可接受的(中位数:9.5),但对提供者来说还有改进的余地(中位数:7.3)。建议包括加强数据传递格式。即使在试点形式下,提供者也发现即时患者体验反馈已融入实践(中位数 10;平均:8.6)。基于 NPT 的分析表明,提供者如何看到不同的价值、参与并将患者反馈用于重新配置实践。

结论

虽然在推广之前还有改进的机会,但一种创新的即时患者体验反馈被认为是有用、可行和可接受的。

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