这篇博客是为了纪念我们的朋友和 我的同事Vanessa Iglesias,注册会计师.
每100个新生儿中, 我出生时患有先天性心脏缺陷(CHD), and many of these babies have additional healthcare needs after their 初步诊断. 这种终身疾病需要持续护理, well beyond the services provided by even highly specialized pediatric cardiologists, who see patients born with CHDs through their adolescence and sometimes longer.
当病人长到16岁时, they begin transitioning to adult medicine and are expected to take more ownership of their care. 疾病预防控制中心对这一人群进行了研究, and their findings emphasize the importance of transitioning from pediatric to adult medical care with a heart doctor. 根据这项研究, ongoing specialty care helps people with heart defects live as healthy a life as possible.
Children’s hospitals across the nation have invested in programmatic efforts to assist CHD patients, but as their survival rate increases due to advances in surgical and medical management, the number of these patients who live into adulthood is growing. 因此, there is a corresponding need to invest in robust and comprehensive CHD transition programs.
We identified three actionable initiatives that children’s hospitals should consider to implement a high-quality, 低成本冠心病过渡方案. These initiatives are based on our personal experiences, 过去与客户合作的项目, 还有顶级儿童医院的采访.
1. Build a partnership with a comprehensive adult cardiovascular program.
Care delivery for these patients requires extensive coordination, from detecting CHDs in newborns to managing transitions of care with specialized, board-certified cardiologists during a patient’s later adolescence. The easiest way to manage this is by partnering with an organization that has an established cardiology practice.
Building a successful roadmap for such a partnership starts with establishing a shared governance model. 如果实施得当, joint operating committees can manage the location of service, 能力的发展, and operational planning to support the transition program. Highly integrated programs provide dual privileges to their providers, 与手术, 电生理学, 成像, and diagnostic procedures shared between the two organizations. The partnership can also help detect CHDs in newborns or even during prenatal care, as well as assist CHD patients in transitioning from pediatric to adult medicine.
2. 绘制过渡教育资源和运作图.
CHD transition education is primarily about informing the patient in a manner that allows them to retain and synthesize the information they need to manage their health going forward. 虽然每个病人的需求是不同的, standardizing and centralizing CHD transition resources can benefit the system overall by reducing variability and tailoring resources as appropriate based on unique patient circumstances.
在办公室访问和测试, CHD patients already spend an extensive amount of time with their cardiologist for care. A patient often spends two to three hours in a cardiologist’s office for each visit and testing. 结果是, many CHD-specialized pediatric cardiologists do not recommend including a 15‑minute appointment at the end of a visit for transition education. 而不是, this should be provided in a separate session with the patient, 他们的父母或监护人, 还有一个专门的过渡团队. Organizations that manage this well standardize the forum (i.e.,虚拟或亲自),格式(i.e., the content and how it is presented), and the team (e.g.(集中的冠心病转诊护士).
Mapping these resources and operations should be a business planning effort achieved through your partnership’s shared governance model. A certain level of investment will be necessary to provide transition education due to a lack of reimbursement by many payers for this service. 然而, 当这个过程被有效地执行时, it allows the patient to manage their health while continuing to receive care from the partnership system for ongoing CHD treatment.
3. Develop the right content for education based on your patients.
Transition programs educate patients on how to manage their own care as an adult. 这包括提供有关保险的信息, 紧急情况下联系谁, 以及关于冠心病患者的生活应该知道些什么. 这种教育不是一蹴而就的, 为了更有效, it must meet the specific needs of each particular patient.
Organizations should work with their clinical education teams to develop content that is both informative and interactive. The “gamification” of certain content—making it engaging for the patient—is an important aspect of education that can include hands‑on activities during the transition process.
成功的转型管理
For organizations that focus on developing comprehensive cardiac care, CHD转换应该是一项关键bet8娱乐. Many of our clients acknowledge there is a lot of opportunity to improve the way CHD transitions are managed. Focusing on the three initiatives above can elevate your organization’s ability to educate CHD patients and encourage them to participate in their own care.
注:我们要感谢Mark Schwartz, 导演, 心脏bet8娱乐热线, 费城儿童医院, 还有艾米丽·拉克斯切尔, MD, Attending Physician with the Philadelphia Adult Congenital Heart Center and the Division of Cardiology at 费城儿童医院, for speaking with us about the challenges and opportunities associated with building a CHD transition program.
你是如何定义
你的企业心脏病学策略?
2021年6月7日出版