Minnesota Rural Palliative Care Initiative: Building Palliative Care Capacity in Rural Minnesota
Minnesota Rural Palliative Care Initiative: Building Palliative Care Capacity in Rural Minnesota
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DOI：
10.1089/jpm.2012.0324
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发表时间：
2013-03-01
影响因子：
2.8
通讯作者：
McKinley, Deb
中科院分区：
文献类型：
--
作者：
Ceronsky, Lyn;Shearer, Janelle;McKinley, Deb
背景：农村医院和社区在提供姑息治疗方面存在巨大差距，尽管农村人口往往不成比例地成为老年人和慢性病患者。很少有研究调查了什么样的姑息治疗模式在农村社区是可持续的。方法：我们在18个月的时间里研究了一种新的方法对明尼苏达州10个农村社区团队的姑息治疗项目发展的影响。明尼苏达州农村姑息治疗倡议（MRPCI）包括一个由社区能力理论、学习合作模式和国家质量论坛（NQF）姑息治疗和临终关怀质量首选实践组成的三管其下的框架。结果：MRPCI证实了使用该框架在农村社区建设姑息治疗能力的可行性。到18个月结束时，所有10个小组都确定了目标人群，制定并完善了行动计划，并包括至少两项战略，以解决与NQF首选做法相关的社区需求或差距。在MRPCI开始时，只有一个社区有现有的姑息治疗计划。在合作过程中，另外五个社区建立了一个核心团队来实施姑息治疗项目。结论：姑息治疗在农村社区发展是必要的，设想一个结合结构、问责制、定制指导、工具和跨环境网络的项目是成功的关键。
Background: Significant gaps exist in the availability of palliative care in rural hospitals and communities, even though rural populations are often disproportionately elderly and chronically ill. Few studies have examined what models of palliative care would be sustainable in a rural community.Methods: We studied the effects of a novel approach to palliative care program development with 10 rural Minnesota community teams over 18 months. The Minnesota Rural Palliative Care Initiative (MRPCI) included a three-prong framework consisting of community capacity theory, a learning collaborative model, and the National Quality Forum (NQF) Preferred Practices for Palliative and Hospice Care Quality.Results: MRPCI confirmed the feasibility of building palliative care capacity in rural communities using this framework. By the end of the 18 months, all 10 teams had identified a target population, developed and refined an action plan, and included at least two strategies to address community needs or gaps related to NQF preferred practices. Only one community had an existing palliative care program at the start of the MRPCI. During the course of the collaborative, five additional communities built a core team to implement a palliative care program.Conclusions: Palliative care development is necessary in rural communities, and envisioning a program that combines structure, accountability, customized guidance, tools, and networking across settings is essential for success.