Hospital collaboration with emergency medical services in the care of patients with acute myocardial infarction: perspectives from key hospital staff.
Hospital collaboration with emergency medical services in the care of patients with acute myocardial infarction: perspectives from key hospital staff.
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DOI：
10.1016/j.annemergmed.2012.10.009
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发表时间：
2013-02
影响因子：
6.2
通讯作者：
Curry, Leslie A.
中科院分区：
文献类型：
--
作者：
Landman, Adam B.;Spatz, Erica S.;Cherlin, Emily J.;Krumholz, Harlan M.;Bradley, Elizabeth H.;Curry, Leslie A.
有证据表明，医院和急诊医疗服务（EMS）之间的积极合作与较低的急性心肌梗死（AMI）死亡率显著相关;然而，这种合作的性质还没有得到很好的理解。我们试图描述关键医院工作人员关于与EMS合作治疗AMI住院患者的观点。我们对之前从现场访问和深入访谈中收集的定性数据进行了探索性分析，这些数据来自11家美国医院，这些医院使用2005-2007年医疗保险和医疗补助服务中心的数据，在30天风险标准化AMI死亡率（RSMRs）方面排名前5%或后5%。我们从第一次分析中选择了最有可能讨论EMS的所有代码。一个多学科的团队分析了数据，使用不断的比较方法，以产生经常性的主题。绩效较高和较低的医院都报告说，EMS是为AMI患者提供及时护理的关键。然而，与EMS的密切合作关系在绩效较高的医院中更为明显。表现较好的医院表现出对EMS的具体投资和关注：1）尊重EMS作为有价值的专业人员和同事; 2）与EMS的强有力沟通和协调; 3）EMS积极参与医院AMI质量改进工作。来自高绩效医院的医院工作人员描述了广泛的、多方面的策略，以支持与EMS合作提供AMI护理。这些策略与医院绩效之间的关联应该在一个更大的、有代表性的研究中进行定量测试。
Evidence suggests that active collaboration between hospitals and emergency medical services (EMS) is significantly associated with lower acute myocardial infarction (AMI) mortality rates; however, the nature of such collaborations is not well understood. We sought to characterize views of key hospital staff regarding collaboration with EMS in the care of patients hospitalized with AMI. We performed an exploratory analysis of qualitative data previously collected from site visits and in-depth interviews with 11 US hospitals that ranked in the top or bottom 5% of performance on 30-day risk-standardized AMI mortality rates (RSMRs) using Centers for Medicare and Medicaid Services data from 2005–2007. We selected all codes from the first analysis in which EMS was most likely to have been discussed. A multidisciplinary team analyzed the data using the constant comparative method to generate recurrent themes. Both higher and lower performing hospitals reported that EMS is critical to the provision of timely care for patients with AMI. However, close, collaborative relationships with EMS were more apparent in the higher performing hospitals. Higher performing hospitals demonstrated specific investment in and attention to EMS through: 1) respect for EMS as valued professionals and colleagues; 2) strong communication and coordination with EMS; and 3) active engagement of EMS in hospital AMI quality improvement efforts. Hospital staff from higher performing hospitals described broad, multifaceted strategies to support collaboration with EMS in providing AMI care. The association of these strategies with hospital performance should be tested quantitatively in a larger, representative study.
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DOI：
10.1161/circoutcomes.109.883256
发表时间：
2009-09-01
影响因子：
6.9
作者：
Krumholz, Harlan M.;Merrill, Angela R.;Drye, Elizabeth E.
通讯作者：
Drye, Elizabeth E.
影响因子：
--
作者：
Leonard, M;Graham, S;Bonacum, D
通讯作者：
Bonacum, D
影响因子：
2.4
作者：
Landman, Adam B.;Rokos, Ivan C.;Bogucki, Sandy
通讯作者：
Bogucki, Sandy
影响因子：
2.9
作者：
Capella, Jeannette;Smith, Stephen;ReMine, Stephen
通讯作者：
ReMine, Stephen
影响因子：
4.4
作者：
Baumlin, Kevin M.;Genes, Nicholas;Janiak, Bruce
通讯作者：
Janiak, Bruce