Can facility-based transitional care improve patient flow? Lessons from four Canadian regions.
Can facility-based transitional care improve patient flow? Lessons from four Canadian regions.
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DOI：
10.1177/0840470421995934
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发表时间：
2021-05
影响因子：
--
通讯作者：
Goertzen LN
中科院分区：
文献类型：
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作者：
Kreindler SA;Struthers A;Star N;Bowen S;Hastings S;Winters S;Johnson K;Mallinson S;Brierley M;Anwar MR;Aboud Z;Basran J;Goertzen LN
提供过渡性、亚急性或恢复性护理的单元是一种促进患者流动和改善低视力(通常是老年)住院患者预后的常见干预措施；然而，人们对加拿大卫生系统使用这种“过渡性单元”的经验知之甚少。这项对四个卫生区域不同单位的比较案例研究(48次访谈)确定了重要的成功因素和陷阱。成功的一个基本要求是明确定义单位的目标人群，并围绕其需求设计模型。规划者还必须确保该单位获得资源和工作人员，以提供真正的恢复性护理。最后，必须开发简化的流程，以帮助患者进入和通过该单元。被认为更有效的单位似乎已经令人满意地解决了这些人口、能力和流程问题，而那些被认为效率较低的单位继续与这些问题作斗争。调查结果提出了支持过渡单位最佳设计和实施的原则。
Units providing transitional, subacute, or restorative care represent a common intervention to facilitate patient flow and improve outcomes for lower acuity (often older) inpatients; however, little is known about Canadian health systems’ experiences with such “transition units.” This comparative case study of diverse units in four health regions (48 interviews) identified important success factors and pitfalls. A fundamental requirement for success is to clearly define the unit’s intended population and design the model around its needs. Planners must also ensure that the unit be resourced and staffed to deliver truly restorative care. Finally, streamlined processes must be developed to help patients access and move through the unit. Units that were perceived as more effective appeared to have satisfactorily addressed these population, capacity, and process issues, whereas those perceived as less effective continued to struggle with them. Findings suggest principles to support optimal design and implementation of transition units.