Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study.
Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study.
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DOI：
10.1089/jpm.2016.0433
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发表时间：
2017-10
影响因子：
2.8
通讯作者：
Taylor DH Jr
中科院分区：
文献类型：
--
作者：
Bhavsar NA;Bloom K;Nicolla J;Gable C;Goodman A;Olson A;Harker M;Bull J;Taylor DH Jr
背景：随着人口老龄化及其益处证据的增加，姑息治疗的使用大幅增加。然而，关于哪些护理活动对于提供高质量、跨学科、基于社区的姑息治疗是必要的，信息有限。目的：本研究旨在识别和衡量由多学科团队在临终关怀服务提供者主导的模型中完成的离散临床和管理活动，以提供基于社区的姑息治疗。研究设计：在大型临终关怀和姑息治疗网络内的三个护理机构进行了时间和运动研究，并绘制了流程图来描述记录的人员和活动。方法：研究人员记录临床和行政人员的活动。活动分为与患者护理、行政职责、护理协调等相关的活动。创建了姑息治疗服务的流程图，并使用描述性统计数据来计算花在离散活动和每个活动类别内的时间比例。结果：记录了超过 50 个小时的活动，在此期间临床医生与 25 名患者互动并从事 20 项不同的任务。医生 94% 的时间花在与患者护理相关的任务上，1% 的时间花在行政任务上。执业护士和注册护士分别将 82% 和 53% 的时间花在与患者相关的任务上，将 2% 和 37% 的时间花在行政任务上。结论：姑息治疗的提供是跨学科的，涉及许多离散的任务和活动。了解基于社区的姑息治疗模式的组成部分是设计鼓励其传播的激励措施的第一步。
Background: Use of palliative care has increased substantially as the population ages and as evidence for its benefits grows. However, there is limited information regarding which care activities are necessary for delivering high-quality, interdisciplinary, community-based palliative care. Objectives: This study aims to identify and measure the discrete clinical and administrative activities completed by a multidisciplinary team in a hospice provider-led model for providing community-based palliative care. Study Design: A time and motion study was conducted at three care settings within a large hospice and palliative care network and a process map was drawn to describe the personnel and activities recorded. Methods: Researchers recorded activities performed by clinical and administrative staff. Activities were categorized into those related to patient care, administrative duties, care coordination, and other. A process map of palliative care delivery was created and descriptive statistics were used to calculate the proportion of time spent on discrete activities and within each activity category. Results: Over 50 hours of activities were recorded during which the clinicians interacted with 25 patients and engaged in 20 distinct tasks. Physicians spent 94% of their time on tasks related to patient care and 1% on administrative tasks. Nurse practitioners and registered nurses spent 82% and 53% of their time on patient-related tasks and 2% and 37% on administrative tasks, respectively. Conclusion: The delivery of palliative care is interdisciplinary and involves numerous discrete tasks and activities. Understanding the components of a community-based palliative care model is the first step to designing incentives to encourage its spread.
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影响因子：
39
作者：
Kutner JS;Blatchford PJ;Taylor DH Jr;Ritchie CS;Bull JH;Fairclough DL;Hanson LC;LeBlanc TW;Samsa GP;Wolf S;Aziz NM;Currow DC;Ferrell B;Wagner-Johnston N;Zafar SY;Cleary JF;Dev S;Goode PS;Kamal AH;Kassner C;Kvale EA;McCallum JG;Ogunseitan AB;Pantilat SZ;Portenoy RK;Prince-Paul M;Sloan JA;Swetz KM;Von Gunten CF;Abernethy AP
通讯作者：
Abernethy AP
DOI：
10.1007/s00464-016-4855-4
发表时间：
2016-11-01
影响因子：
3.1
作者：
Aitchison, Lucy Ping;Cui, Cathy Kexin;Abbott, Jason
通讯作者：
Abbott, Jason
影响因子：
2.6
作者：
Kim, Christopher S.;Lovejoy, William;Flanders, Scott A.
通讯作者：
Flanders, Scott A.
DOI：
10.15171/ijhpm.2015.76
发表时间：
2015-07-01
影响因子：
3.5
作者：
Sampalli, Tara;Desy, Michel;Blackmore, Gail
通讯作者：
Blackmore, Gail
影响因子：
4.3
作者：
Warner, Courtney J.;Walsh, Daniel B.;Powell, Richard J.
通讯作者：
Powell, Richard J.