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20世纪90年代的重症监护管理。实现协作实践。

Critical care management in the 1990s. Making collaborative practice work.

作者信息

Miccolo M A, Spanier A H

机构信息

Adult Critical Care Services, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

出版信息

Crit Care Clin. 1993 Jul;9(3):443-53.

PMID:8353783
Abstract

The creation of a partnership, the hallmark of true collaborative practice, is an ongoing, dynamic process. It demands commitment, energy, and creativity. It is learned and therefore must be role modeled. One must remember that it takes time to develop collaborative relationships. One must begin slowly, walk not run, and have realistic expectations. It is a joy to work in an environment that has developed and is in the process of continually developing true collaborative practice. Hope for the future of health care lies in our ability to deliver coordinated and collaborative care. Nursing, medicine, and administration together can and must provide the solutions to our health care delivery problems before those solutions are legislated. We must set policies and priorities to appropriately allocate scarce resources. We must address personnel needs, credentialing, and compensation to ensure adequate numbers of qualified staff to meet the growing needs of our patients. We must evaluate technology and our physical environments to determine the types of services that we will offer. We must continue to broaden our collaborative efforts to extend from the patient care arena into the realms of education, research, and administration. It is up to each of us and each of our colleagues to work every day toward a more collaborative practice environment. By empowering each other, we can put into place a collaboration which "works jointly with others in intellectual endeavors" rather than one which merely "cooperates with an enemy force."

摘要

建立伙伴关系作为真正合作实践的标志,是一个持续、动态的过程。它需要投入、精力和创造力。它是可以习得的,因此必须树立榜样。必须记住,发展合作关系需要时间。必须慢慢来,循序渐进,抱有现实的期望。在一个已经建立并正在持续发展真正合作实践的环境中工作是一种乐趣。医疗保健的未来希望在于我们提供协调和合作护理的能力。护理、医学和管理部门能够而且必须共同在立法之前为我们的医疗保健提供问题找到解决方案。我们必须制定政策和优先事项,以适当分配稀缺资源。我们必须解决人员需求、资质认证和薪酬问题,以确保有足够数量的合格工作人员来满足患者不断增长的需求。我们必须评估技术和物理环境,以确定我们将提供的服务类型。我们必须继续扩大合作努力,从患者护理领域扩展到教育、研究和管理领域。我们每个人和我们的每一位同事都有责任每天朝着更具合作性的实践环境努力。通过相互赋能,我们可以建立一种“在智力活动中与他人共同努力”的合作,而不是仅仅“与敌对力量合作”的合作。

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