The Patient Journey for Children with Medical Complexity during Pandemic Era andits implications.

项目摘要/摘要 CMC是一小部分有特殊卫生保健需求的儿童和青年 用于不到1-5%的儿童，但消耗超过三分之一的卫生保健资源。他们是 增加了多次和长时间住院的风险，医疗保健使用效率低下 资源、频繁的医疗差错、糟糕的健康结果、重大的未得到满足的健康需求 服务，以及对家庭照顾者的压力。这种复杂性和相关问题一直是 COVID大流行进一步加剧了这一趋势。小说的兴起 冠状病毒(新冠肺炎)改变了动态，推动了整个 这可能会产生长期的影响，并可能成为“新常态”。 在这项探索性研究中，我们的首要目标是了解新冠肺炎是如何流行的 影响CMC护理患者的旅程。我们将获取多个利益相关者的经验 与CMC护理相关，包括住院医生、儿科门诊提供者、家庭护士、 CMC照顾者和患者。这些发现将有助于正在进行的重新设计和改进的努力 特别是在新冠肺炎疫情带来的新挑战的情况下，CMC予以关注。这个 该项目的目标是：1)对COVID进行多个利益相关者360度分析 CMC患者在不同环境中使用Quality的体验 以及人为因素技术。2)定量评估项目的有用性和经验 远程医疗在CMC护理中的使用，以及3)评估大流行对健康的影响 使用回溯性图表审查的结果/利用率CMC。研究团队处于有利地位 解决CMC人群的拟议目标，从而指导确定潜在的 改善CMC护理的干预措施。这是对CMC关怀的创新、深入和丰富的分析 在大流行期间使用新的人为因素方法的病人旅程将提供 非常有价值的信息，不仅对CMC，而且对其他类似复杂的护理环境 和病人群体。

Project Summary/Abstract CMC are a small proportion of children and youth with special health care needs that account for less than 1-5% of all children but consume over one third of health care resources. They are at increased risk of multiple and prolonged hospitalizations, inefficient use of healthcare resources, frequent medical errors, poor health outcomes, significant unmet needs for health services, and stress on family caregivers. This complexity and related problems have been and continue to be even further exacerbated by the COVID pandemic. The rise of the novel coronavirus (COVID-19) changed dynamics and contributed to a paradigm shift in the overall health care practice which will probably have long lasting impact and may be the “new normal”. In this exploratory study, our overarching goal is to understand how COVID-19 Pandemic impacted CMC care patient journey. We will capture the experience of multi stakeholders associated with CMC care including hospitalists, pediatrics outpatient providers, home nurses, CMC caregivers and patients. The findings will help the ongoing efforts to redesign and improve CMC care especially in the light of new challenges introduced by the COVID-19 Pandemic. The aims of the project are to: 1) Perform a multi-stakeholder 360-degree analysis of the COVID experience for CMC patients across different settings in their patient journey using qualitative and human factors techniques. 2) Quantitatively evaluate usefulness and experience of Telehealth use in CMC care, and 3) Evaluate the impact of pandemic on health outcome/utilization CMC using retrospective chart review. The research team is well positioned to address the proposed aims for the CMC population and thus guide identification of potential interventions to improve CMC care. This innovative, in-depth, and rich analysis of the CMC care patient journey during the pandemic using novel human factors methodologies will provide highly valuable information, not only for CMC, but also for other similarly complex care settings and patient populations.