PALLIATIVE CARE EDUCATION THROUGH QUALITY IMPROVEMENT

描述：(申请人的描述)取得了重大进展 在治疗晚期疼痛和其他症状方面取得了进展 生病了。然而，当地和医学文献中的研究表明， 大量的患者没有足够的疼痛缓解和 生前的其他问题。姑息治疗的质量，是 依赖于复杂的医疗保健提供系统，以及 协调一个跨学科的提供者团队，除了 有足够的知识和技能。为了改善姑息治疗 交付，医生必须能够在团队中工作，并需要 了解卫生保健提供流程的改进。在这件事上 项目，医科学生，作为纵向临床的一部分 经验丰富，将参与一项跨学科的素质 由护士、专职医生、临终关怀团队成员组成的改进团队， 支持工作人员和驻院医生开发关键路径 在三家医院接受姑息治疗。关键途径将是 确定向晚期癌症患者提供护理的步骤， 并将提供有关姑息治疗过程的持续教育 照顾那些参与照顾这些病人的人。医疗 学生们将从全球范围内了解如何护理因 临终关怀工作人员、患者和家属、医院工作人员和图表审查 作为质量改进过程数据收集的一部分。 以问题为基础的互动课程是对这方面知识的补充。 一旦开发，一条姑息治疗的关键途径和 整合和持续改进途径的进程将 通过诺里斯棉花癌传播给其他机构 中心肿瘤学外展计划，佛蒙特州质量计划 医疗保健和退伍军人管理局国家道德中心。 我们的具体目标是：1)发展持续的姑息治疗 医学生、住院医师和专职医师教育计划 以及包括临终关怀团队成员在内的其他医疗专业人员。2) 培养医学生对跨学科的认识 医疗团队，以及通过以下方式改善医疗系统的手段 质量改进的努力。3)使用持续改进过程 开发提供姑息治疗的关键途径 三个场景，白河交界处退伍军人医疗中心， 阿斯卡尼山医院和达特茅斯希区柯克医疗中心。 通过以下方式创建自我永续的姑息护理质量改进 实施关键途径和持续评价以及 对该途径的修饰。

DESCRIPTION: (Applicant's Description) Significant advances have been made in the management of pain and other symptoms in the terminally ill. Studies locally and in the medical literature, however, indicate that large numbers of patients have in adequate relief of pain and other problems prior to death. Quality in palliative care, is dependent on a complex health care delivery system, and the coordination of an interdisciplinary team of providers,in addition to adequate knowledge and skills. In order to improve palliative care delivery, physicians must be able to work within a team and need to understand improvement of health care delivery processes. In this project, medical students, as part of a longitudinal clinical experience, will participate in an interdisciplinary quality improvement team with nurses, staff physicians, hospice team members, support staff and resident physicians to develop a critical pathway for palliative care at three hospitals. The critical pathway will identify steps for delivery of care to terminally ill cancer patients, and will provide on-going education about the process for palliative care to those involved in caring for these patients. Medical students will gain a global understanding of care of the dying from hospice staff, patients and families, hospital staff and chart reviews as part of the data collection for the quality improvement process. A problem-based and interactive curriculum supplements this knowledge. Once developed, a critical pathway for palliative care and the process for integration and ongoing improvement of the pathway will be disseminated to other institutions through the Norris Cotton Cancer Center oncology outreach program, the Vermont Program for Quality in Health Care, and the Veterans Administration National Ethics Center. Our specific aims are to: 1) Develop an ongoing palliative care education program for medical students, resident and staff physicians and other healthcare professionals including hospice team members.2) Foster an understanding for medical students of interdisciplinary healthcare teams, and means of improving healthcare systems through quality improvement efforts.3) Use a continual improvement process to develop a critical pathway for delivering palliative care in three settings, the White River Junction VA Medical Center, the Mount Ascutney Hospital and the Dartmouth Hitchcock Medical Center. Create self-perpetuating palliative care quality improvement through implementation of the critical pathway and ongoing evaluation and modification of the pathway.