Task shifting in primary care to tackle healthcare worker shortages: An umbrella review.
Task shifting in primary care to tackle healthcare worker shortages: An umbrella review.
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DOI：
10.1080/13814788.2021.1954616
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Lee SWH
中科院分区：
文献类型：
--
作者：
Leong SL;Teoh SL;Fun WH;Lee SWH
任务转移是通过重新分配人力资源来帮助解决医疗工作者短缺问题的一种方法，但其对初级保健的影响尚不清楚。提供描述初级保健中从医生到专职医护人员的任务转移及其对临床结局影响的综述概述。检索了截至2020年12月15日的6个电子数据库，以识别描述初级保健任务转移的综述。两名评价者独立筛选相关研究的参考文献，提取数据，并使用AMSTAR-2评估纳入综述的方法学质量。21篇综述描述了初级保健中的任务转移。转移的任务包括为慢性病患者提供护理、开药和健康教育。我们发现，任务转移可能会改善一些健康结果，如血压，HbA 1c和心理健康，同时节省成本。成功实施任务转移的关键要素包括各方之间的合作，协调护理系统，提供者授权，患者偏好，共同决策，培训和能力，支持性组织系统，明确的过程结果和融资。有证据表明，专职医疗工作者，如药剂师和护士，可以承担大大扩展的作用，以支持医生在初级保健，以应对不断变化的卫生服务需求。任务包括为病人提供护理、独立开药、咨询和教育，并提供可比的护理质量。
Task shifting is an approach to help address the shortage of healthcare workers through reallocating human resources but its impact on primary care is unclear. To provide an overview of reviews describing task shifts from physicians to allied healthcare workers in primary care and its impact on clinical outcomes. Six electronic databases were searched up to 15 December 2020, to identify reviews describing task shifting in primary care. Two reviewers independently screened the references for relevant studies, extracted the data and assessed the methodological quality of included reviews using AMSTAR-2. Twenty-one reviews that described task shifting in primary care were included. Task shifted include provision of care for people with chronic conditions, medication prescribing, and health education. We found that task shifting could potentially improve several health outcomes such as blood pressure, HbA1c, and mental health while achieving cost savings. Key elements for successful implementation of task shifting include collaboration among all parties, a system for coordinated care, provider empowerment, patient preference, shared decision making, training and competency, supportive organisation system, clear process outcome, and financing. Evidence suggests that allied healthcare workers such as pharmacists and nurses can potentially undertake substantially expanded roles to support physicians in primary care in response to the changing health service demand. Tasks include providing care to patients, independent prescribing, counselling and education, with comparable quality of care.
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