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临床医生对麻醉、外科手术和初级保健围手术期作用及职责的看法。

Clinician perspectives on the perioperative roles and responsibilities of anesthesia, surgery, and primary care.

作者信息

Ron Donna, Ballacchino Madison M, Briggs Alexandra, Deiner Stacie G

机构信息

Department of Community and Family Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH, 03756, USA; Department of Anesthesiology and Perioperative Medicine, Dartmouth Hitchcock Medical Center and Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH, 03756, USA.

Jacobs School of Medicine and Biomedical Sciences, 955 Main St, Buffalo, NY, 14203, USA.

出版信息

Am J Surg. 2025 Mar;241:115948. doi: 10.1016/j.amjsurg.2024.115948. Epub 2024 Sep 1.

Abstract

BACKGROUND

Although high-risk older patients benefit from a multidisciplinary approach to perioperative care, the specific roles and responsibilities of the clinicians involved have yet to be adequately characterized.

METHODS

Qualitative analysis of semi-structured interviews with four anesthesia preoperative clinic providers, seven surgeons, and nine primary care providers in northern New England.

RESULTS

The analysis revealed both distinct and overlapping roles and responsibilities. Anesthesia providers were described as a "safety net" and surgeons as "captain of the ship", in charge of getting "all the ducks in a row" to avoid surgery delays and cancellations. Primary care providers saw themselves as the "quarterback", ensuring care continuity and consideration of patient psychosocial factors.

CONCLUSIONS

While all have a shared responsibility for facilitating patient-centered decision-making and a safe perioperative course, each discipline has different areas of focus and expertise. Role clarification can help optimize the distribution of responsibilities and enhance perioperative communication and collaboration.

摘要

背景

尽管高危老年患者受益于围手术期护理的多学科方法,但相关临床医生的具体角色和职责尚未得到充分界定。

方法

对新英格兰北部的四名麻醉术前诊所工作人员、七名外科医生和九名初级保健提供者进行半结构化访谈,并进行定性分析。

结果

分析揭示了不同但又相互重叠的角色和职责。麻醉提供者被描述为“安全网”,外科医生则是“船长”,负责把“所有事情都安排妥当”以避免手术延误和取消。初级保健提供者将自己视为“四分卫”,确保护理的连续性并考虑患者的社会心理因素。

结论

虽然所有人都有共同责任促进以患者为中心的决策制定和安全的围手术期过程,但每个学科都有不同的关注领域和专业知识。明确角色有助于优化职责分配并加强围手术期的沟通与协作。

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