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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway
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Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway

机译：进行协作的快速现实主义者审查以研究在成功实施脆弱的老年人通道中起作用的方法

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摘要

We addressed the research question “what factors enable the successful development and implementation of a frail older person’s pathway within the acute setting”. A rapid realist review (RRR) was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources)-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE) study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person’s pathway.
机译：我们解决了研究问题“在急性环境中哪些因素能够成功开发和实施脆弱的老年人的途径”。通过采用RAMESES标准进行了快速的现实主义者审查（RRR）。我们首先通过数据库搜索对232篇文章进行了示例，并补充了94条其他记录，包括来自Twitter聊天和医院实地访问的输入。我们的最终样本包括18个文档。经过专家小组的审查和共识，我们确定了上下文机制（资源）-结果的概念模型。急诊医院的前门应确认总体脆弱。所发现的重大挑战与急性环境和外部环境中的组织边界有关，需要将结果转移到以患者为导向的方面，以通过提供持续的教育和提供角色明确性来支持员工维持这一途径。存款准备金率可以根据广泛的来源并与利益相关者进行创新性参与来制定有效的方法说明，从而为诸如改善脆弱的老年人护理的系统方法之类的研究提供支持。从我们的临时模型中可以明显看出，许多因素需要结合并相互作用，以实现并维持成功的脆弱老年人的道路。

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