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首页> 外文期刊>Internal medicine journal >Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care.
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Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care.

机译：针对急性病住院患者的多学科护理小组的对照试验：增强的多学科护理。

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BACKGROUND: Acute hospital general medicine services care for ageing complex patients, using the skills of a range of health-care providers. Evidence suggests that comprehensive early assessment and discharge planning may improve efficiency and outcomes of care in older medical patients. AIM: To enhance assessment, communication, care and discharge planning by restructuring consistent, patient-centred multidisciplinary teams in a general medicine service. METHODS: Prospective controlled trial enrolling 1538 consecutive medical inpatients. Intervention units with additional allied health staff formed consistent multidisciplinary teams aligned with inpatient admitting units rather than wards; implemented improved communication processes for early information collection and sharing between disciplines; and specified shared explicit discharge goals. Control units continued traditional, referral-based multidisciplinary models with existing staffing levels. RESULTS: Access to allied health services was significantly enhanced. There was a trend to reduced index length of stay in the intervention units (7.3 days vs 7.8 days in control units, P = 0.18), with no change in 6-month readmissions. In-hospital mortality was reduced from 6.4 to 3.9% (P = 0.03); less patients experienced functional decline in hospital (P = 0.04) and patients' ratings of health status improved (P = 0.02). Additional staffing costs were balanced by potential bed-day savings. CONCLUSION: This model of enhanced multidisciplinary inpatient care has provided sustainable efficiency gains for the hospital and improved patient outcomes.
机译：背景：急性医院普通药物服务利用一系列医疗保健提供者的技能为复杂的老年患者提供护理。有证据表明，全面的早期评估和出院计划可能会提高老年医学患者的护理效率和结果。目的：通过在一般医疗服务中重组以患者为中心的一致的多学科团队，加强评估，沟通，护理和出院计划。方法：前瞻性对照试验招募了1538名连续的住院患者。具有额外专职医疗人员的干预单位组成了统一的多学科团队，与住院患者而不是病房保持一致;为各学科之间的早期信息收集和共享实施了改进的沟通流程;并指定了共享的明确放电目标。控制单位继续采用现有人员配备水平的传统，基于推荐的多学科模型。结果：获得专职医疗服务的机会大大增加。干预组的住院时间有减少的趋势（对照组为7.3天，对照组为7.8天，P = 0.18），6个月再入院率没有变化。住院死亡率从6.4％降低到3.9％（P = 0.03）;较少的患者经历了医院的功能下降（P = 0.04），并且患者的健康状况评分得到改善（P = 0.02）。额外的人事费用与潜在的卧床日费用保持平衡。结论：这种加强多学科住院治疗的模型为医院提供了可持续的效率提高，并改善了患者的预后。

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