■在健康和社会护理组织以及专业人员之间共享有关患者的数据,比如他们用药的细节,对于提供协调和以人为本的护理至关重要。虽然专业人士可以通过多种方式共享数据-例如,通过共享的电子记录系统或多学科团队会议-有许多因素使跨健康和社会护理边界共享数据变得困难。这些包括专业等级制度,无法访问的电子系统和对机密性的担忧。数据共享对于老年人的护理尤为重要,因为它们更有可能具有多个或长期条件;需要了解如何实现有效的数据共享。
■为了确定被认为影响有效数据共享的因素,包括成功采用干预措施来改善数据共享,在医疗保健和社会护理组织以及有关老年人护理的专业人员之间。
■MEDLINE和其他七个数据库(2023年3月)进行了定性和混合方法研究。搜索相关网站,并在纳入的研究中完成引文追逐。如果研究集中在老年人身上,根据研究的定义,和数据共享,定义为医疗保健和社会护理组织之间的信息传递,或护理专业人员,关于一个病人,并在英国进行。使用有目的的采样来获得一组最终的研究,这些研究使用框架合成进行了分析。使用华莱士检查表进行质量评估。在整个项目中咨询了利益相关者以及公众和患者参与小组。
■包括24项研究;在质量评估清单上得分最高。确定了四个主要主题。在目标中,我们发现了数据共享的五个目的:联合(健康和社会护理)评估,综合案件管理,从医院到家,对于养老院的居民来说,还有姑息治疗.在关系中,建立专业间的关系,因此,信任和尊重,在专业人员之间支持数据共享,而专业偏见和不信任的存在阻碍了它。组织间过程和程序,例如对正式协议的关心和实施的共同愿景,例如数据治理,支持数据共享。在技术和基础设施方面,使用技术作为支持数据共享的工具,专业人士对更广泛的护理系统的认识也是如此。还有影响数据共享的具体因素与其目的有关;例如,在姑息治疗领域缺乏法律框架。
■数据共享通常是在更广泛的倡议的背景下讨论的,例如综合护理,这意味着提供的信息通常是有限的。COVID-19大流行对工作方式产生了重大影响;我们没有一项纳入的研究是在大流行期间或之后进行的。
■我们的发现表明了建立专业间关系并确保专业人员能够以多种方式共享数据的重要性。
■需要探索由于COVID-19大流行而采用的新技术和工作方式对数据共享的影响。此外,研究应探索患者体验和预防健康和社会护理专业人员中的数字排斥。
■该协议已在PROSPEROCRD42023416621上注册。
■该奖项由美国国立卫生与护理研究所(NIHR)卫生与社会护理提供研究计划(NIHR奖项参考:NIHR135660)资助。作为授予NIHR130538的一系列证据综合的一部分,并在《健康与社会护理交付研究》中全文发表;第一卷。12号12.有关更多奖项信息,请参阅NIHR资助和奖励网站。
健康和社会护理组织和专业人员需要共享有关老年人的数据。数据-例如,药物的细节-可以以不同的方式分享,例如电子记录系统,团队会议。分享数据很重要,特别是对于患有多种或长期疾病的人,因为他们可能需要健康和社会护理服务的协调帮助。然而,专业人士经常发现很难共享数据。例如,他们可能担心机密性,或者可能无法访问相同的电子记录系统。这篇综述调查了影响健康和社会护理之间数据共享的因素。我们发现了24项使用焦点小组或访谈等方法的研究。我们发现在研究中共享数据的五个主要目的:评估人们对健康和社会护理的需求,以协调对有现有需求的人的护理,以帮助人们从医院搬到家中,照顾住在养老院的人,以支持临终护理。帮助健康和社会护理专业人员共享数据的因素包括:相互信任和尊重,在他们的组织之间制定适当的政策和流程,了解为什么其他专业人员需要数据。新技术可以帮助专业人员共享数据,但它们需要成为人们正常工作方式的一部分。这些发现可能有助于改善数据共享,因为它们表明专业人员需要多种方式来共享数据。他们还建议需要更多的研究,以便新技术支持数据共享。利益相关者——例如,医生,社会工作者,以及公众和患者代表-在整个项目中提供反馈。该综述包含1995年至2023年3月之间发表的研究。
UNASSIGNED: Sharing data about patients between health and social care organisations and professionals, such as details of their medication, is essential to provide co-ordinated and person-centred care. While professionals can share data in a number of ways - for example, through shared electronic record systems or multidisciplinary team meetings - there are many factors that make sharing data across the health and social care boundary difficult. These include professional hierarchies, inaccessible electronic systems and concerns around confidentiality. Data-sharing is particularly important for the care of older people, as they are more likely to have multiple or long-term conditions; understanding is needed on how to enable effective data-sharing.
UNASSIGNED: To identify factors perceived as influencing effective data-sharing, including the successful adoption of interventions to improve data-sharing, between healthcare and social care organisations and professionals regarding the care of older people.
UNASSIGNED: MEDLINE and seven further databases were searched (in March 2023) for qualitative and mixed-methods studies. Relevant websites were searched and citation-chasing completed on included studies. Studies were included if they focused on older people, as defined by the study, and data-sharing, defined as the transfer of information between healthcare and social care organisations, or care professionals, regarding a patient, and were conducted in the United Kingdom. Purposive sampling was used to obtain a final set of studies which were analysed using framework synthesis. Quality appraisal was conducted using the Wallace checklist. Stakeholder and public and patient involvement groups were consulted throughout the project.
UNASSIGNED: Twenty-four studies were included; most scored highly on the quality appraisal checklist. Four main themes were identified. Within Goals, we found five purposes of data-sharing: joint (health and social care) assessment, integrated case management, transitions from hospital to home, for residents of care homes, and for palliative care. In Relationships, building interprofessional relationships, and therefore trust and respect, between professionals supported data-sharing, while the presence of professional prejudices and mistrust hindered it. Interorganisational Processes and procedures, such as a shared vision of care and operationalisation of formal agreements, for example data governance, supported data-sharing. Within Technology and infrastructure, the use of technology as a tool supported data-sharing, as did professionals\' awareness of the wider care system. There were also specific factors influencing data-sharing related to its purpose; for example, there was a lack of legal frameworks in the area of palliative care.
UNASSIGNED: Data-sharing was usually discussed in the context of wider initiatives, for example integrated care, which meant the information provided was often limited. The COVID-19 pandemic has had significant impacts on ways of working; none of our included studies were conducted during or since the pandemic.
UNASSIGNED: Our findings indicate the importance of building interprofessional relationships and ensuring that professionals are able to share data in multiple ways.
UNASSIGNED: Exploration of the impact of new technologies and ways of working adopted as a result of the COVID-19 pandemic on data-sharing is needed. Additionally, research should explore patient experience and the prevention of digital exclusion among health and social care professionals.
UNASSIGNED: The protocol was registered on PROSPERO CRD42023416621.
UNASSIGNED: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135660), as part of a series of evidence syntheses under award NIHR130538, and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 12. See the NIHR Funding and Awards website for further award information.
Health and social care organisations and professionals need to share data about older people. Data – for example, details of medication – can be shared in different ways, for example electronic records systems, team meetings. Sharing data is important, especially for people with multiple or long-term conditions as they may need co-ordinated help from health and social care services. However, professionals often find it difficult to share data. For example, they may have concerns about confidentiality or may not have access to the same electronic record systems. This review investigated factors that influence data-sharing between health and social care. We found 24 studies that used methods such as focus groups or interviews. We found five main purposes of sharing data in the studies: to assess people’s need for health and social care to co-ordinate care for people with existing needs to help people move from hospital to home to care for people living in care homes to support end-of-life care. Factors that help health and social care professionals share data include: having trust and respect for each other having suitable policies and processes in place between their organisations having an awareness of why other professionals need data. New technologies can help professionals share data, but they need to be part of the normal way that people work. These findings could help to improve data-sharing as they show that professionals need multiple ways of sharing data. They also suggest more research is needed so that new technology supports data-sharing. Stakeholders – for example, doctors, social workers, and public and patient representatives – provided feedback throughout the project. The review contains studies published between 1995 and March 2023.