Guiding Post-Hospital Recovery by 'What Matters:' Implementation of Patient Priorities Identification in a VA Community Living Center.
Guiding Post-Hospital Recovery by 'What Matters:' Implementation of Patient Priorities Identification in a VA Community Living Center.
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DOI：
10.3390/geriatrics8040074
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发表时间：
2023-07-04
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背景：患者优先护理(PPC)是一种有效的年龄友好型卫生系统(AFHS)方法，可使护理与“重要的”目标保持一致。该质量改进计划的目的是评估退伍军人社区生活中心(CLC)健康优先识别(HPI)过程的保真度和可行性。方法：PPC专家与当地CLC工作人员合作，指导HPI与CLC的整合，并利用计划-做-研究-行动(PDSA)模式进行质量改进项目。PPC专家审查了健康优先事项确定(HPI)会议和跨学科团队(IDT)会议，以确保PPC的HPI过程的忠诚度。对当地CLC工作人员的定性访谈确定了CLC确定健康优先事项过程的适当性。结果：在8个月的时间里，9名主持人完成了20次HPI会面。开发患者健康优先注意事项模板、工作人员教育和PPC促进员培训提高了电子健康记录中HPI遭遇的保真度和记录。促进者访谈表明，PPC在这种情况下是合适的，不会给工作人员带来负担，并促进了以人为中心的AFHS方法。结论：HPI过程是一种可接受和可行的方法，可以在CLC环境中询问AFHS的“什么是重要的”组成部分。
Background: Patient priorities care (PPC) is an effective age-friendly health systems (AFHS) approach to aligning care with goals derived from ‘what matters’. The purpose of this quality improvement program was to evaluate the fidelity and feasibility of the health priorities identification (HPI) process in VA Community Living Centers (CLC). Methods: PPC experts worked with local CLC staff to guide the integration of HPI into the CLC and utilized a Plan–Do–Study–Act (PDSA) model for this quality improvement project. PPC experts reviewed health priorities identification (HPI) encounters and interdisciplinary team (IDT) meetings for fidelity to the HPI process of PPC. Qualitative interviews with local CLC staff determined the appropriateness of the health priorities identification process in the CLC. Results: Over 8 months, nine facilitators completed twenty HPI encounters. Development of a Patient Health Priorities note template, staff education and PPC facilitator training improved fidelity and documentation of HPI encounters in the electronic health record. Facilitator interviews suggested that PPC is appropriate in this setting, not burdensome to staff and fostered a person-centered approach to AFHS. Conclusions: The HPI process is an acceptable and feasible approach to ask the ‘what matters’ component of AFHS in a CLC setting.