Sustaining clinical programs during difficult economic times: a case series from the Hospital Elder Life Program.
Sustaining clinical programs during difficult economic times: a case series from the Hospital Elder Life Program.
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DOI：
10.1111/j.1532-5415.2011.03585.x
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发表时间：
2011-10
影响因子：
6.3
通讯作者：
Inouye SK
中科院分区：
文献类型：
--
作者：
SteelFisher GK;Martin LA;Dowal SL;Inouye SK
以医院老年人生活计划 (HELP) 为例，探讨临床计划所使用的策略，以向决策者证明手术的合理性。HELP 是一项基于证据、具有成本效益的计划，旨在改善住院老年人的护理。定性研究设计采用了 2008 年 9 月至 2009 年 8 月期间对 HELP 工作人员和医院管理人员进行的 62 次深入、半结构化访谈。美国和加拿大医院的 19 个 HELP 站点已招募患者至少 6 个月。 HELP 工作人员和医院管理人员在面临实际或感知的财务威胁时维持该计划的经验，重点关注他们认为能够有效向医院或卫生系统决策者证明该计划合理性的因素。使用持续比较方法（一种标准的定性分析技术），在访谈中确定了三个主要主题。每一项都侧重于成功证明该计划合理性并确保持续运营资金的策略：1）与决策者进行有意义的互动，包括展示运营成功的正式演示，以及强调 HELP 对医院或卫生系统的好处的非正式方式； 2) 以与决策者优先事项相一致的指标记录日常运营成功； 3) 获得影响行政决策的有影响力的医院工作人员的支持，特别是护士和医生。由于临床项目面临财务挑战，因此找到有效的方法向决策者证明其运营的合理性非常重要。这里描述的策略可能有助于临床有效和具有成本效益的项目得以维持，从而有助于改善其机构的护理。
To explore strategies used by clinical programs to justify operations to decision-makers using the example of the Hospital Elder Life Program (HELP), an evidence-based, cost-effective program to improve care for hospitalized older adults. Qualitative study design utilizing 62 in-depth, semi-structured interviews conducted with HELP staff members and hospital administrators between September 2008 and August 2009. 19 HELP sites in hospitals across the U.S. and Canada that had been recruiting patients for at least 6 months. HELP staff and hospital administrator experiences sustaining the program in the face of actual or perceived financial threats, with a focus on factors they believe are effective in justifying the program to decision-makers in the hospital or health system. Using the constant comparative method, a standard qualitative analysis technique, three major themes were identified across interviews. Each focuses on a strategy for successfully justifying the program and securing funds for continued operations: 1) interact meaningfully with decision-makers, including formal presentations that showcase operational successes, and also informal means that highlight the benefits of HELP to the hospital or health system; 2) document day-to-day, operational successes in metrics that resonate with decision-maker priorities; and 3) garner support from influential hospital staff that feed into administrative decision-making, particularly nurses and physicians. As clinical programs face financially challenging times, it is important to find effective ways to justify their operations to decision-makers. Strategies described here may help clinically-effective and cost-effective programs sustain themselves, and thus may help improve care in their institutions.
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影响因子：
158.5
作者：
Inouye, SK;Bogardus, ST;Cooney, LW
通讯作者：
Cooney, LW
影响因子：
3
作者：
Reuben, DB
通讯作者：
Reuben, DB
影响因子：
3
作者：
Rizzo, JA;Bogardus, ST;Inouye, SK
通讯作者：
Inouye, SK
DOI：
10.1111/j.1532-5415.2004.52510.x
发表时间：
2004-11-01
影响因子：
6.3
作者：
Bradley, EH;Schlesinger, M;Inouye, SK
通讯作者：
Inouye, SK
DOI：
10.1111/j.1532-5415.2005.53451.x
发表时间：
2005-09-01
影响因子：
6.3
作者：
Bradley, EH;Webster, TR;Inouye, SK
通讯作者：
Inouye, SK