Practices to support relational coordination in care transitions: Observations from the VA rural Transitions Nurse Program.

IF 1.7 3区 医学 Q3 HEALTH POLICY & SERVICES
Heather M Gilmartin, Catherine Battaglia, Theodore Warsavage, Brigid Connelly, Robert E Burke
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引用次数: 11

Abstract

Background: Ensuring safe transitions of care around hospital discharge requires effective relationships and communication between health care teams. Relational coordination (RC) is a process of communicating and relating for the purpose of task integration that predicts desirable outcomes for patients and providers. RC can be measured using a validated survey.

Purpose: The aim of the study was to demonstrate the application of RC practices within the rural Transitions Nurse Program (TNP), a nationwide transitions of care intervention for Veterans, and assess relationships and mechanisms for developing RC in teams.

Methodology/approach: TNP implemented practices expected to support RC. These included creation of a transition nurse role, preimplementation site visits, process mapping to understand workflow, creation of standardized communication templates and protocols, and inclusion of teamwork and shared accountability in job descriptions and annual reviews. We used the RC Survey to measure RC for TNP health care teams. Associations between the months each site participated in TNP, number of Veterans enrolled, and adherence to the TNP intervention were assessed as possible mechanisms for developing high RC using Spearman (rs) correlations.

Results: The RC Survey was completed by 44 providers from 11 Veterans Health Administration medical centers. RC scores were high across sites (mean = 4.19; 1-5 Likert scale) and were positively correlated with months participating in TNP (rs = .66) and number of enrollees (rs = .63), but not with adherence to the TNP intervention (rs = .12).

Practice implications: The impact of practices to support RC can be assessed using the RC Survey. Our findings suggest scale-up time is a likely mechanism to the development of high-quality relationships and communication within teams.

在护理过渡中支持关系协调的实践:来自VA农村过渡护士项目的观察。
背景:确保出院前后护理的安全过渡需要卫生保健团队之间有效的关系和沟通。关系协调(RC)是一种以任务整合为目的的沟通和关联过程,可以预测患者和提供者的理想结果。RC可以通过有效的调查来测量。目的:本研究的目的是展示农村过渡护士计划(TNP)在全国退伍军人护理过渡干预中的应用,并评估团队中发展RC的关系和机制。方法论/方法:TNP实施的实践有望支持RC。这些措施包括设立过渡护士角色、实施前实地考察、绘制流程图以了解工作流程、创建标准化沟通模板和协议,以及在工作描述和年度审查中纳入团队合作和共同责任。我们使用RC调查来衡量TNP卫生保健团队的RC。使用Spearman (rs)相关性,评估每个站点参与TNP的月份、参加TNP的退伍军人数量和对TNP干预的依从性之间的关联,作为产生高RC的可能机制。结果:RC调查由11个退伍军人健康管理医疗中心的44个提供者完成。各个部位的RC评分都很高(平均= 4.19;1-5 Likert量表),与参加TNP的月份(rs = 0.66)和参加TNP的人数(rs = 0.63)呈正相关,但与TNP干预的依从性无关(rs = 0.12)。实践影响:可以使用RC调查来评估支持RC的实践的影响。我们的研究结果表明,扩大时间可能是团队内部发展高质量关系和沟通的机制。
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来源期刊
Health Care Management Review
Health Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
期刊介绍: Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.
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