Veldhuizen Jessica, Schuurmans Marieke, Mikkers Misja, Bleijenberg Nienke
Research Centre for Healthy and Sustainable Living, Faculty of Health Care, University of Applied Sciences Utrecht, 3584 CS Utrecht, The Netherlands.
Department of Education, University Medical Center Groningen, 9700 AB Groningen, The Netherlands.
Healthcare (Basel). 2024 Dec 21;12(24):2576. doi: 10.3390/healthcare12242576.
The increasing complexity of healthcare needs driven by an ageing population places pressure on district nursing care. Many vulnerable older adults prefer to remain at home, requiring care coordinated with general practitioners and other professionals. This demand for integrated care is further challenged by a shortage of nursing professionals and the lack of standardised approaches to measure care quality. This article identifies the key requirements for implementing a learning healthcare system in district nursing care, using patient outcome data to foster continuous improvement and create a more adaptive, evidence-based, and patient-centred approach. This paper synthesises findings from multiple studies conducted as part of a PhD thesis, utilising a multi-method approach. These methods include examining patient outcomes in district nursing care and evaluating necessary cultural, organisational, and financial changes. Four key requirements were identified: (1) standardising patient outcome measures; (2) fostering a data-driven culture and strengthening professional autonomy; (3) enhancing organisational support and integrated care; and (4) adopting financing models that incentivise continuous learning and quality improvement. Implementing a learning healthcare system with patient outcome data in district nursing care requires a transformative shift. Standardising outcome measures, investing in information systems, and promoting continuous learning are crucial. Aligning financial incentives with patient outcomes, strengthening professional autonomy, and enhancing organisational support can make district nursing more responsive and capable of meeting complex needs. The described requirements are essential for advancing district nursing care through a more adaptive, evidence-based, and patient-centred approach.
人口老龄化导致医疗保健需求日益复杂,给社区护理带来了压力。许多体弱的老年人更愿意居家养老,这就需要与全科医生及其他专业人员协调护理工作。护理专业人员短缺以及缺乏衡量护理质量的标准化方法,使这种综合护理的需求面临进一步挑战。本文确定了在社区护理中实施学习型医疗保健系统的关键要求,即利用患者结局数据促进持续改进,并创建一种更具适应性、基于证据且以患者为中心的方法。本文综合了作为博士论文一部分进行的多项研究结果,采用了多方法途径。这些方法包括检查社区护理中的患者结局,以及评估必要的文化、组织和财务变革。确定了四个关键要求:(1)使患者结局指标标准化;(2)培育数据驱动的文化并加强专业自主权;(3)加强组织支持和综合护理;(4)采用激励持续学习和质量改进的融资模式。在社区护理中利用患者结局数据实施学习型医疗保健系统需要进行变革性转变。使结局指标标准化、投资信息系统以及促进持续学习至关重要。使财务激励与患者结局保持一致、加强专业自主权并增强组织支持,可以使社区护理更具响应能力,并能够满足复杂需求。上述要求对于通过更具适应性、基于证据且以患者为中心的方法推进社区护理至关重要。