■为了研究质量改进计划(桥梁),旨在促进康复服务的协调和连续性,由提供者在风湿性和肌肉骨骼疾病患者的常规实践中交付和感知。
■一种收敛混合方法方法嵌套在阶梯式楔形中,随机对照试验。制定干预计划是为了弥合二级和初级医疗保健之间的差距,包括以下要素:动机性访谈;针对患者的目标设定;书面康复计划;对进展的个性化反馈;以及量身定制的后续行动。分别收集和分析了实施该计划的卫生专业人员的数据,使用两份问卷和三个焦点小组。在整体解释和讨论过程中整合了结果。
■程序的交付取决于提供者的技能和能力,以及他们团队和机构中的环境因素。建议的改进可能性包括在近亲和外部服务的充分支持下采取后续行动,以及行动和应对计划的实践,标准化结果测量,以及对进展的反馈。
■领导者和临床医生应讨论努力,以确保在个体提供者的水平上提供自信和合格的康复服务。团队,和机构,并同等关注从入院到后续过程中的每个组成部分。对康复的影响康复质量应从目标设定到后续行动的连续和协调过程来表征。为了提高质量,需要近亲和外部服务的充分参与。临床医生可能需要培训来建立动机面试的信心,行动和应对计划,对进展的反馈,和后续行动。领导人应该组织教育会议,优化时间表,插入标准化结果衡量标准,并促进跨护理和服务级别的协作。
UNASSIGNED: To investigate how a quality improvement program (BRIDGE), designed to promote coordination and continuity in rehabilitation services, was delivered and perceived by providers in routine practice for patients with rheumatic and musculoskeletal diseases.
UNASSIGNED: A convergent mixed methods approach was nested within a stepped-wedge, randomized controlled trial. The intervention program was developed to bridge gaps between secondary and primary healthcare, comprising the following elements: motivational interviewing; patient-specific goal setting; written rehabilitation-plans; personalized feedback on progress; and tailored follow-up. Data from health professionals who delivered the program were collected and analyzed separately, using two questionnaires and three focus groups. Results were integrated during the overall interpretation and discussion.
UNASSIGNED: The program delivery depended on the providers\' skills and competence, as well as on contextual factors in their teams and institutions. Suggested possibilities for improvements included follow-up with sufficient support from next of kin and external services, and the practicing of action and coping plans, standardized outcome measures, and feedback on progress.
UNASSIGNED: Leaders and clinicians should discuss efforts to ensure confident and qualified rehabilitation delivery at the levels of individual providers, teams, and institutions, and pay equal attention to each component in the process from admission to follow-up.
Quality in rehabilitation should be characterized by a continuous and coordinated process from goal setting to follow-up.To improve the quality, sufficient involvement of next of kin and external services is needed.Clinicians may need training to build confidence in motivational interviewing, action- and coping planning, feedback on progress, and follow-up.Leaders should organize education sessions, optimize schedules, insert standardized outcome measures, and facilitate collaboration across levels of care and services.