PDF(Pubmed)
Abstract：
BACKGROUND: Health systems have long been interested in the best practices for staffing in the acute care setting. Studies on staffing often focus on registered nurses and nurse-to-patient staffing ratios. There were fewer studies on the relationship between interprofessional team members or contextual factors such as hospital and community characteristics and patient outcomes. This qualitative study aimed to refine an explanatory model by soliciting hospital personnel feedback on staffing and patient outcomes.
METHODS: We conducted a qualitative study using semi-structured interviews and thematic analysis to understand hospital personnel\'s perspectives and experiences of factors that affect acute care inpatient outcomes. Interviews were conducted in 2022 with 38 hospital personnel representing 19 hospitals across Washington state in the United States of America.
RESULTS: Findings support a model of characteristics impacting patient outcomes to include the complex and interconnected relationships between community, hospital, patient, and staffing characteristics. Within the model, patient characteristics were positioned into hospital characteristics, and in turn these were positioned within community characteristics to highlight the importance of setting and context when evaluating outcomes. Together, these factors influenced both staff characteristics and patient outcomes, but these two categories also share a direct relationship.
CONCLUSIONS: Findings can be applied to hospitals and health systems in a variety of contexts to examine how external factors such as community resource availability impact care delivery. Future research should expand on this work with specific attention to how staffing changes and interprofessional team composition can improve patient outcomes.
METHODS: We conducted a qualitative study using semi-structured interviews and thematic analysis to understand hospital personnel\'s perspectives and experiences of factors that affect acute care inpatient outcomes. Interviews were conducted in 2022 with 38 hospital personnel representing 19 hospitals across Washington state in the United States of America.
RESULTS: Findings support a model of characteristics impacting patient outcomes to include the complex and interconnected relationships between community, hospital, patient, and staffing characteristics. Within the model, patient characteristics were positioned into hospital characteristics, and in turn these were positioned within community characteristics to highlight the importance of setting and context when evaluating outcomes. Together, these factors influenced both staff characteristics and patient outcomes, but these two categories also share a direct relationship.
CONCLUSIONS: Findings can be applied to hospitals and health systems in a variety of contexts to examine how external factors such as community resource availability impact care delivery. Future research should expand on this work with specific attention to how staffing changes and interprofessional team composition can improve patient outcomes.
摘要：
背景：卫生系统长期以来一直对急性护理环境中人员配备的最佳实践感兴趣。关于人员配备的研究通常集中在注册护士和护士与患者的人员配备比率上。关于跨专业团队成员或医院和社区特征等环境因素与患者预后之间关系的研究较少。这项定性研究旨在通过征求医院人员对人员配备和患者结果的反馈来完善解释模型。
方法：我们使用半结构化访谈和主题分析进行了一项定性研究，以了解医院人员对影响急性护理住院结果的因素的观点和经验。2022年进行了采访，代表美国华盛顿州19家医院的38名医院人员。
结果：研究结果支持影响患者预后的特征模型，包括社区之间复杂和相互关联的关系，医院,病人,和人员配备特点。在模型中，患者特征被定位为医院特征，反过来，这些被定位在社区特征中，以突出评估结果时设置和背景的重要性。一起,这些因素影响了工作人员的特征和患者的预后，但是这两个类别也有直接的关系。
结论：研究结果可应用于各种情况下的医院和卫生系统，以检查诸如社区资源可用性等外部因素如何影响护理提供。未来的研究应该扩大这项工作，特别关注人员配置的变化和跨专业团队的组成如何改善患者的预后。
方法：我们使用半结构化访谈和主题分析进行了一项定性研究，以了解医院人员对影响急性护理住院结果的因素的观点和经验。2022年进行了采访，代表美国华盛顿州19家医院的38名医院人员。
结果：研究结果支持影响患者预后的特征模型，包括社区之间复杂和相互关联的关系，医院,病人,和人员配备特点。在模型中，患者特征被定位为医院特征，反过来，这些被定位在社区特征中，以突出评估结果时设置和背景的重要性。一起,这些因素影响了工作人员的特征和患者的预后，但是这两个类别也有直接的关系。
结论：研究结果可应用于各种情况下的医院和卫生系统，以检查诸如社区资源可用性等外部因素如何影响护理提供。未来的研究应该扩大这项工作，特别关注人员配置的变化和跨专业团队的组成如何改善患者的预后。
