Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay - A nine-hospital study of surgical patients
Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay - A nine-hospital study of surgical patients
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DOI：
10.1097/00005650-200008000-00005
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发表时间：
2000-08-01
期刊：
影响因子：
3
通讯作者：
Zuckerman, J
中科院分区：
文献类型：
--
作者：
Gittell, JH;Fairfield, KM;Zuckerman, J
背景医疗保健组织面临着来自患者的压力，要求提高护理质量和临床结果，以及来自管理式护理的压力，要求更有效地这样做。协调，任务的相互依赖性的管理，是一种方式，卫生保健组织试图满足这些相互冲突的需求。本研究的目的是引入关系协调的概念，并确定其对护理质量，术后疼痛和功能的影响;以及接受择期手术的患者的住院时间。关系协调包括频繁，及时，准确的沟通，以及解决问题，共同的目标，共享的知识，以及医疗保健提供者之间的相互尊重。关系的协调性是通过一个横截面问卷的卫生保健提供者。通过对全髋关节和膝关节置换术患者进行横断面术后问卷调查来衡量护理质量。在同一问卷中，通过WOMAC骨关节炎工具测量术后疼痛和功能。住院时间从个体患者的医院记录中测量。本研究的受试者为338名护理人员和878名患者，他们在1997年7月至12月期间从马萨诸塞州波士顿、纽约州纽约和德克萨斯州达拉斯的9家医院完成了问卷调查。护理质量、术后疼痛和功能以及急性住院时间。不同地点之间的关系协调性差异显著，在3.86 ~ 4.22之间（P
BACKGROUND. Health care organizations face pressures from patients to improve the quality of care and clinical outcomes, as well as pressures from managed care to do so more efficiently. Coordination, the management of task interdependencies, is one way that health care organizations have attempted to meet these conflicting demands.OBJECTIVES. The objectives of this study were to introduce the concept of relational coordination and to determine its impact on the quality of care, postoperative pain and functioning; and the length of stay for patients undergoing an elective surgical procedure. Relational coordination comprises frequent, timely, accurate communication, as well as problem-solving, shared goals, shared knowledge, and mutual respect among health care providers.RESEARCH DESIGN. Relational coordination was measured by a cross-sectional questionnaire of health care providers. Quality of care was measured by a cross-sectional postoperative questionnaire of total hip and knee arthroplasty patients. On the same questionnaire, postoperative pain and functioning were measured by the WOMAC osteoarthritis instrument. Length of stay was measured from individual patient hospital records.SUBJECTS. The subjects for this study were 338 care providers and 878 patients who completed questionnaires from 9 hospitals in Boston, MA, New York, NY, and Dallas, TX, between July and December 1997.MEASURES. Quality of care, postoperative pain and functioning, and length of acute hospital stay.RESULTS. Relational coordination varied significantly between sites, ranging from 3.86 to 4.22 (P