Addressing the Community-Based Geriatric Healthcare Workforce Shortage by Leveraging the Potential of Interprofessional Teams
Addressing the Community-Based Geriatric Healthcare Workforce Shortage by Leveraging the Potential of Interprofessional Teams
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DOI：
10.1111/jgs.15924
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发表时间：
2019-05-01
影响因子：
6.3
通讯作者：
Bartels, Stephen J.
中科院分区：
文献类型：
--
作者：
Flaherty, Ellen;Bartels, Stephen J.
随着美国人寿命的延长，我们将看到老年人对优质医疗保健的需求不断增加。尽管老年人数量增加，但足以满足老年人护理和健康需求的初级保健医生队伍的供应将会减少。本文回顾了探讨如何解决社区老年医疗保健环境中初级保健劳动力短缺问题的文献，特别关注提升护士和护理人员的作用，并改变我们对提供护理以及临终对话和规划的思考方式。这种转变是转向一种更加综合和协作的护理方法，其中医疗和非医疗、社会服务和社区提供者都发挥作用。一些模型已经向患者、家庭和提供者等展示了有希望的积极效益和结果。目标是提供高质量的护理，解决老年人的独特属性，特别是那些病情复杂的老年人，并更多地关注护理目标和优先事项。在不同环境中扩展和传播护理模式的许多障碍包括支付结构、所有利益相关者缺乏教育和培训，以及首当其冲的领导阻力。我们解决这些障碍，并就前进的道路提出建议，使医疗保健提供者、政策制定者、患者、家庭和其他相关人员都可以在塑造照顾老年人的劳动力方面发挥作用。 J Am Geriatr Soc 67：S400-S408，2019。
As Americans live longer lives, we will see an increased demand for quality healthcare for older adults. Despite the growth in the number of older adults, there will be a decrease in the supply of a primary care physician workforce to provide adequately for their care and health needs. This article reviews the literature that explores ways to address the primary care workforce shortage in a community-based geriatric healthcare setting, with special attention to elevating the role of nurses and caregivers and shifting the way we think about delivery of care and end-of-life conversations and planning. The shift is toward a more integrated and collaborative approach to care where medical and nonmedical, social services, and community providers all play a role. Several models have demonstrated promising positive benefits and outcomes to patients, families, and providers alike. The goal is to provide high quality care that addresses the unique attributes of older adults, especially those with complex conditions, and to focus more on care goals and priorities. The many barriers to scaling and spreading models of care across varied settings include payment structures, lack of education and training among all stakeholders, and, at the top of the list, leadership resistance. We address these barriers and make recommendations for a path forward where healthcare providers, policymakers, patients, families, and everyone else involved can play a role in shaping the workforce caring for older adults. J Am Geriatr Soc 67:S400-S408, 2019.