Palliative Workforce Development and a Regional Training Program
Palliative Workforce Development and a Regional Training Program
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DOI：
10.1177/1049909116685046
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发表时间：
2018-01-01
影响因子：
1.9
通讯作者：
Deamant, Catherine
中科院分区：
文献类型：
--
作者：
O'Mahony, Sean;Levine, Stacie;Deamant, Catherine
目的：我们的主要目的是评估当地医院劳动力的增长，劳动力组成的变化和跨学科团队的使用，以及参加芝加哥地区姑息治疗培训计划的医院姑息治疗团队的支持来源。方法：对16个地点的PC项目主管和管理人员进行电子调查，了解机构和PC项目的特点，如：医院类型、床位数、PC人员组成、提供的PC项目、启动年份、PC服务利用率以及2012和2014财政年度的财政支持来源。结果：2012年现有项目报告的咨询中位数为345 (IQR 109 - 2168)，而2014年为840 （IQR 320 - 4268）。与此同时，整体团队规模有小幅增长，从2012年3.2个全职等效职位（FTE）的中位数增长到2013年的3.3个全职等效职位，中位数增长了0.4 （IQR 0-1.0）。在拥有包括社工和高级执业护士在内的姑息医疗团队的医院的急性护理环境中，出院到临终关怀比死亡更常见（p < 0.0001）。结论：鉴于姑息医学专科医生的短缺，应更加重视培训其他临床医生提供初级姑息治疗，同时解决雇佣足够的劳动力来照顾重症患者的需求。
Aims: Our primary aims were to assess growth in the local hospital based workforce, changes in the composition of the workforce and use of an interdisciplinary team, and sources of support for palliative medicine teams in hospitals participating in a regional palliative training program in Chicago.Methods: PC program directors and administrators at 16 sites were sent an electronic survey on institutional and PC program characteristics such as: hospital type, number of beds, PC staffing composition, PC programs offered, start-up years, PC service utilization and sources of financial support for fiscal years 2012 and 2014.Results: The median number of consultations reported for existing programs in 2012 was 345 (IQR 109 - 2168) compared with 840 (IQR 320 - 4268) in 2014. At the same time there were small increases in the overall team size from a median of 3.2 full time equivalent positions (FTE) in 2012 to 3.3 FTE in 2013, with a median increase of 0.4 (IQR 0-1.0). Discharge to hospice was more common than deaths in the acute care setting in hospitals with palliative medicine teams that included both social workers and advanced practice nurses (p < .0001).Conclusions: Given the shortage of palliative medicine specialist providers more emphasis should be placed on training other clinicians to provide primary level palliative care while addressing the need to hire sufficient workforce to care for seriously ill patients.