Département des sciences administratives, Université du Québec en Outaouais, Gatineau, QC, Canada.
Département des sciences comptables, Université du Québec en Outaouais, Gatineau, QC, Canada.
JMIR Form Res. 2024 Nov 26;8:e60222. doi: 10.2196/60222.
Health-system fragmentation in Quebec significantly impacts care coordination, leading to interruptions in patients' care pathways and adverse effects on their health. Coordinating interfacility service corridors is complex and requires collaboration between multiple health care providers (HCPs) and care settings. Effective care coordination is essential to ensure optimal patient management at transition points.
This study aims to improve oncology and nononcology thoracic surgery care pathways by enhancing care coordination during interfacility transfers through a digital health solution.
A multicenter implementation study was conducted across 2 health regions and 2 health care facilities in Quebec. We conducted 27 semistructured interviews with HCPs and managers to better understand the care pathways. Participatory design workshops were held with future users and key stakeholders at an early stage of the technology's design to validate the prototype's functionalities and workflows. A web survey was sent to all end users (N=13) to assess their experience with the platform.
All participants (100%) either "agreed" or "strongly agreed" that the platform provided significant benefits. It enhanced interestablishment coordination (4/13, 31% agreed and 9/13, 69% strongly agreed) and continuity of care and services (8/13, 62% agreed and 5/13, 38% strongly agreed), and it contributed to better management and patient intake (10/13, 77% agreed and 3/13, 23% strongly agreed) and process fluidity (3/13, 77% agreed and 3/13, 23% strongly agreed). Surgeons from the McGill University Health Centre confirmed that the platform facilitated and secured information transmission (2/5, 40% agreed and 3/5, 60% strongly agreed) and kept track of oncology patient referrals, follow-up needs, and cases where surgery is unnecessary (2/5, 40% agreed and 3/5, 60% strongly agreed). Nursing staff from the Centre intégré de santé et de services sociaux de l'Outaouais and McGill University Health Centre reported high satisfaction with the platform's support during preoperative visit, surgery, and discharge processes. All participants perceived the platform as intuitive and easy to use. Additionally, participants valued its efficiency in providing rapid access to patient data, which reduces task time and ensures document security, thereby improving care coordination across facilities. The project's success has convinced the HCPs and senior management at both health care facilities to pursue long-term use of the Akinox digital health platform.
This pilot project represents a significant advancement in thoracic surgery care pathways and the coordination of interfacility health care service corridors. The project provides care pathways that are adaptable to other surgical specialties. It also paves the way for improving care in cancer and other health care networks while highlighting the key role of nurse navigators in patient care management. The project underscores the value of strategic leadership and stakeholders' collaboration to improve care coordination and operational efficiency by demonstrating technology's essential role in patient care pathways.
魁北克的医疗体系碎片化严重影响了医疗协调，导致患者的治疗路径中断，对其健康产生不利影响。协调机构间服务走廊非常复杂，需要多个医疗保健提供者（HCP）和护理环境之间的协作。有效的协调对于确保患者在过渡点的最佳管理至关重要。
本研究旨在通过数字化健康解决方案，在机构间转移过程中加强医疗协调，从而改善肿瘤学和非肿瘤学胸外科的治疗路径。
在魁北克的 2 个卫生区和 2 个卫生保健机构进行了一项多中心实施研究。我们对 HCP 和管理人员进行了 27 次半结构式访谈，以更好地了解治疗路径。在技术设计的早期阶段，与未来的用户和主要利益相关者一起举办了参与式设计研讨会，以验证原型的功能和工作流程。向所有最终用户（N=13）发送了网络调查，以评估他们对该平台的使用体验。
所有参与者（100%）都“同意”或“强烈同意”该平台具有显著优势。它增强了入院前的协调（4/13，31%同意，9/13，69%强烈同意）和治疗连续性和服务（8/13，62%同意，5/13，38%强烈同意），并有助于更好地管理和接受患者（10/13，77%同意，3/13，23%强烈同意）以及流程流畅性（3/13，77%同意，3/13，23%强烈同意）。麦吉尔大学健康中心的外科医生证实，该平台促进并保障了信息传输（2/5，40%同意，3/5，60%强烈同意），并跟踪肿瘤患者的转诊、随访需求以及无需手术的情况（2/5，40%同意，3/5，60%强烈同意）。来自安大略省综合卫生与社会服务中心和麦吉尔大学健康中心的护理人员报告称，他们对该平台在术前访问、手术和出院过程中的支持非常满意。所有参与者都认为该平台直观易用。此外，参与者还重视其在快速获取患者数据方面的效率，这减少了任务时间并确保了文件安全，从而改善了机构间的医疗协调。该项目的成功促使这两家医疗机构的 HCP 和高级管理人员都决定长期使用 Akinox 数字化健康平台。
本试点项目代表了胸外科治疗路径和机构间医疗保健服务走廊协调方面的重大进展。该项目提供了适用于其他外科专业的治疗路径。它还为改善癌症和其他医疗保健网络中的治疗铺平了道路，同时强调了护士导航员在患者治疗管理中的关键作用。该项目突显了战略领导力和利益相关者合作的价值，通过展示技术在患者治疗路径中的重要作用，提高了医疗协调和运营效率。
