Service provision for patients with ALS/MND: A cost-effective multidisciplinary approach
Service provision for patients with ALS/MND: A cost-effective multidisciplinary approach
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DOI：
10.1016/s0022-510x(98)00214-7
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发表时间：
1998-10-01
影响因子：
4.4
通讯作者：
Hardiman, O
中科院分区：
文献类型：
--
作者：
Corr, B;Frost, E;Hardiman, O
ALS/MND患者的最佳管理需要团队方法，及早转诊至辅助医疗服务以进行临床评估和及时干预。随着病情的发展，医疗团队必须采取灵活的管理方法，能够在非常短的时间内进行干预。我们开发了一家高效的多学科诊所，通过将现有的社区服务基础设施与以医院为基础的专家诊所相结合，为爱尔兰的ALS/MND人群提供服务。该诊所每周运营一次，由一个核心团队组成，其中包括一名神经科医生、一名联络护士和ALS/MND协会的主任。可以进行现场和当天的物理治疗、作业治疗和语言治疗，以及肺部评估。所有使用临床服务的患者都会自动被列入爱尔兰运动神经元疾病登记册，并由联络护士进行跟踪。诊所的核心成员定期与社区内的辅助医疗工作人员互动，确保在诊所就诊后1-2周内提供必要的社区服务。根据地区辅助医疗人员的适当要求，爱尔兰运动神经元疾病协会免费提供患者健康所需的设备。因此，我们已经证明，通过现有的医疗保健结构和多学科团队的核心成员之间的密切个人联系，可以以适中的成本为ALS/MND开发有效的多学科护理服务。(C)1998 Elsevier Science B.V.保留所有权利。
Optimal management of patients with ALS/MND requires a team approach, with early referral to paramedical services for clinical assessment and prompt intervention. As the condition progresses, a flexible approach to management must be adopted by the medical team, with an ability to intervene at very short notice. We have developed an efficient multi-disciplinary clinic that services the ALS/MND population of Ireland by combining the existing infrastructure of community services with a hospital-based specialist clinic. The clinic operates on a weekly basis, and is staffed by a core team including a neurologist, a liaison nurse, and the director of the ALS/MND Association. On-site and same-day physiotherapy, occupational therapy and speech therapy is available, as is pulmonary evaluation. All patients utilising the clinical services are automatically included on the Irish Register of Motor Neurone Disease, and are tracked by the liaison nurse. The core members of the clinic interact regularly with paramedical staff within the community, ensuring that necessary community services are made available within 1-2 weeks of the clinic visit. Equipment necessary for the patient's well being is made available free of charge by the Irish Motor Neurone Disease Association, following an appropriate request from the regional para-medical staff. We have thus demonstrated that an effective multi- disciplinary care service for ALS/MND can be developed at modest cost by close personal liaison between the existing health care structures and core members of a multidisciplinary team. (C) 1998 Elsevier Science B.V. All rights reserved.