Preventing the preventable: reducing rehospitalizations through coordinated, patient-centered discharge processes.
Preventing the preventable: reducing rehospitalizations through coordinated, patient-centered discharge processes.
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DOI：
10.1097/ncm.0b013e318198d4e1
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发表时间：
2009-05
影响因子：
1.5
通讯作者：
Jack BW
中科院分区：
文献类型：
--
作者：
Greenwald JL;Jack BW
越来越多的文献表明，如果建立旨在识别和解决导致再次住院的一些潜在问题的系统，那么很大一部分再次住院是可以避免的。本文强调了计划外再住院的关键风险因素，并说明了一个项目，成功地解决了许多潜在的问题，有助于他们。本文所述的研究发生在市中心的一家学术教学医院。主动识别患者，临床医生和系统相关的障碍，以成功的出院过渡是至关重要的有效过渡的照顾病人离开医院的设置。这一进程代表着一种文化变革，需要对护理采取多学科办法，并要求明确划分进程中的作用和责任，界定最终和明确的进程所有权。在护理系统中采取这些步骤后，有理由期望减少可预防的再住院。
Growing literature suggests that a significant proportion of rehospitalizations could be prevented if systems were put in place aimed at identifying and addressing some of the underlying issues that cause them. This article highlights key risk factors for unplanned rehospitalizations and illustrates a project that has successfully addressed many of the underlying issues that contribute to them. The study illustrated herein took place at an inner-city academic teaching hospital. Proactively identifying patient-, clinician-, and system-associated barriers to successful discharge transitions is critical for effective transitions of care for patients leaving the hospital setting. This process represents a culture change, requires a multidisciplinary approach to care, and mandates clear delineation of roles and responsibilities in the process, with ultimate and clear process ownership being defined. With such steps in place in a system of care, it is reasonable to expect a reduction in preventable rehospitalizations.