{"id":3621,"date":"2021-02-02T10:31:15","date_gmt":"2021-02-02T10:31:15","guid":{"rendered":"\/?p=3621"},"modified":"2021-02-02T10:31:15","modified_gmt":"2021-02-02T10:31:15","slug":"making-diagnostic-services-more-accessible","status":"publish","type":"post","link":"https:\/\/www.vanguardhealthcare.co.uk\/bs_ba\/making-diagnostic-services-more-accessible\/","title":{"rendered":"U\u010diniti dijagnosti\u010dke usluge pristupa\u010dnijim"},"content":{"rendered":"

Iako je potreba za reformom dijagnosti\u010dkog pru\u017eanja usluga i uvo\u0111enjem novog modela usluga za pru\u017eanje sigurnih puteva usmjerenih na pacijenta ve\u0107 neko vrijeme bila prioritetno podru\u010dje, utjecaj na Covid-19 na dijagnosti\u010dke aktivnosti istaknuo je hitnost s kojom se to mora rije\u0161iti. isporu\u010deno.<\/p>\n

Potreba za reformom dijagnostike i odvajanjem puteva izme\u0111u akutne i elektivne nege istaknuta je u izvje\u0161taj koji je objavio NHS England<\/a> oktobra, \u0161to je nadovezlo na dugoro\u010dni plan.<\/p>\n

Pandemija Covid-19 istakla je brojne slabosti koje uti\u010du na otpornost na\u0161eg zdravstvenog sistema. Ono \u0161to smo nau\u010dili od Covid-19 je da, iako jasno razdvajanje puteva izme\u0111u akutne i elektivne njege mo\u017ee minimizirati negativne efekte na zdravstveni sistem u cjelini; tako\u0111e je neophodno biti u stanju da se efikasno nosimo sa slede\u0107om pandemijom.<\/p>\n

Covid-19 je pogor\u0161ao situaciju<\/strong><\/p>\n

Dok su se britanske bolnice relativno dobro nosile s epidemijom Covid-19, s obzirom na pritisak pod kojim je bila prije izbijanja pandemije, ona je imala ne\u017eeljene efekte na ve\u0107inu neakutnih dijelova zdravstvenog sistema. Termini su otkazani, dijagnosti\u010dke procedure su odgo\u0111ene; i akcije poduzete za osloba\u0111anje kreveta u bolnicama negativno su uticale na pru\u017eanje zdravstvenih usluga u zajednici i smanjile broj kreveta dostupnih u bolnicama za nehitne pacijente.<\/p>\n

Jedan od najvidljivijih efekata je zna\u010dajno pove\u0107anje broja ljudi koji \u010dekaju<\/a> za dijagnosti\u010dke testove i tretmane. Iako je aktivnost porasla od prvog zatvaranja, jo\u0161 se nije oporavila na nivoe prije pandemije, a broj pacijenata je manji, posebno za CT skeniranje i endoskopiju, zbog mjera usmjerenih na smanjenje rizika od infekcije Covid-19.<\/p>\n

Uticaj je bio najve\u0107i na one koji su najdu\u017ee \u010dekali. Do septembra, uprkos zna\u010dajnom porastu aktivnosti, tre\u0107ina pacijenata na listi \u010dekala je vi\u0161e od \u0161est nedelja na skeniranje ili drugi dijagnosti\u010dki test, a za endoskopiju ta brojka je bila preko 50%. Broj pacijenata koji \u010dekaju vi\u0161e od 13 sedmica na endoskopiju pao je sa svog vrhunca u junu, ali se o\u010dekuje da \u0107e najnoviji talas Covid-19 uzrokovati dodatne poreme\u0107aje u uslugama.<\/p>\n

Ono \u0161to tako\u0111e izaziva zabrinutost je 'skriveni zaostatak' odgo\u0111enih preporuka, jer su se i vremena \u010dekanja na zakazivanje sa konsultantom pove\u0107ala. U sistemu koji vodi konsultant sa smanjenim protokom pacijenata, \u010dekanje da se vidi konsultant postaje usko grlo.<\/p>\n

Reforma dijagnosti\u010dkih usluga<\/strong><\/p>\n

Me\u0111utim, pandemija je tako\u0111er pru\u017eila priliku za promjene. Kako je napredovao, fokus se pomjerio sa tra\u017eenja rje\u0161enja za neposrednu krizu, kori\u0161tenjem kratkoro\u010dnih privremenih rje\u0161enja kao \u0161to su bolnice Nightingale, na prilago\u0111avanje dugoro\u010dnom \u017eivotu s rizikom od Covid-19. Ponovo se stavlja naglasak na tra\u017eenje ve\u0107e ugra\u0111ene otpornosti za budu\u0107nost.<\/p>\n

Potreba za radikalnim pobolj\u0161anjem na\u010dina pru\u017eanja dijagnosti\u010dkih usluga bila je \u0161iroko priznata prije pandemije, a potra\u017enja je brzo rasla posebno u posljednjih pet godina, \u0161to je dovelo do pove\u0107anja kr\u0161enja standarda dijagnostike od \u0161est sedmica u posljednjih nekoliko godina.<\/p>\n

Pristup endoskopskoj opremi i objektima ve\u0107 je bio pod velikim optere\u0107enjem prije pandemije, posebno za kolonoskopiju. Procjene zasnovane na Ispravite prvi put (GIRFT)<\/a> Program pokazuje da \u0107e oko 20 fondova NHS-a vjerovatno zahtijevati potpunu rekonstrukciju svojih endoskopskih objekata, dok je ostalima potrebno pobolj\u0161anje.<\/p>\n

Iako ne postoji nacionalni registar imovine za endoskopske ustanove, izvje\u0161taj<\/a> Objavljeno od strane Public Policy Projects u partnerstvu sa Vanguard prije dvije godine pokazalo je da oko 25% bolnica ima komplete i opremu za endoskopsku dekontaminaciju koja je stara vi\u0161e od deset godina.<\/p>\n

Jasno je da se ne radi samo o ulaganju u zgrade i opremu. Pored pove\u0107anog kapaciteta, radna snaga \u0107e se morati pro\u0161iriti, a novi modeli usluga \u0107e morati da isporu\u010de kompletan set dijagnosti\u010dkih usluga izvan bolni\u010dkih okru\u017eenja.<\/p>\n

Dijagnostika: oporavak i obnova<\/strong><\/p>\n

Predlo\u017eeno rje\u0161enje izneseno je u nedavni izvje\u0161taj<\/a>, na osnovu pregleda dijagnosti\u010dkih usluga koje je naru\u010dio NHS Engleska kao dio Dugoro\u010dni plan<\/a>. Zala\u017ee se za razdvajanje akutne i elektivne dijagnostike gdje god je to mogu\u0107e, a prema prijedlogu, samostalna dijagnosti\u010dka \u010dvori\u0161ta bi se postavila u zajednici, daleko od akutnih bolni\u010dkih mjesta, kako bi se omogu\u0107ilo 'one-stop shop' za dijagnosti\u010dke procjene.<\/p>\n

Izvje\u0161taj nagla\u0161ava potrebu za pove\u0107anjem kapaciteta i navodi da je procijenjeno da je potrebno 200 novih endoskopskih soba u NHS Trustovima kako bi se pokrio trenutni rast potra\u017enje i omogu\u0107ilo planirano pro\u0161irenje programa skrininga crijeva. Identificirana je i potreba za zamjenom sve postoje\u0107e opreme za snimanje starije od 10 godina, zajedno s potrebom da se pove\u0107a kapacitet CT skeniranja za 100% u narednih pet godina. Obezbe\u0111enje CT skenera po populaciji u Velikoj Britaniji je mnogo ni\u017ee nego u drugim razvijenim zemljama.<\/p>\n

Ovaj pristup bi doveo do zna\u010dajnog smanjenja broja pacijenata koji pose\u0107uju akutne bolni\u010dke uslove i stvorio efikasnost u celom zdravstvenom sistemu. Od objavljivanja, izvje\u0161taj je univerzalno dobrodo\u0161ao, a ako se preporuke u potpunosti implementiraju, nagovje\u0161tava\u0107e zna\u010dajna ulaganja u radnu snagu, opremu i objekte.<\/p>\n

Fleksibilniji pristup<\/strong><\/p>\n

Pove\u0107anje kapitalne potro\u0161nje od 2,3 milijarde funti u 2021\/22. najavljeno kao dio najnovije revizije potro\u0161nje, koja uklju\u010duje 325 miliona funti za dijagnosti\u010dke ma\u0161ine kao \u0161to su MRI i CT skeneri i za zamjenu stare opreme za snimanje, donekle \u0107e pomo\u0107i u pokrivanju tro\u0161kova .<\/p>\n

Pitanje je da li \u0107e to biti dovoljno, i da li \u0107emo uskoro vidjeti u\u010dinak, da napravi stvarnu razliku u vremenu \u010dekanja i ishodima pacijenata u kratkom i srednjem roku. Za provedbu preporuka u izvje\u0161taju trebat \u0107e vrijeme \u2013 ali s obzirom da zaostaci rastu svakog mjeseca, da li je \u010dekanje opcija?<\/p>\n

Jasno razdvajanje puteva je ve\u0107 mogu\u0107e posti\u0107i kori\u0161tenjem postoje\u0107ih fleksibilna zdravstvena infrastruktura<\/a>, koji se mo\u017ee postaviti bli\u017ee pacijentima kao sastavni dio integrirane mre\u017ee nege. Mobilne i modularne jedinice za snimanje i endoskopiju mogu se postaviti na gotovo bilo kojoj lokaciji kako bi se stvorila samostalna dijagnosti\u010dka ustanova bez Covida u vrlo kratkom vremenskom periodu.<\/p>\n

Dok se mobilne jedinice \u010desto koriste za pru\u017eanje ve\u0107e fleksibilnosti kao dio bolni\u010dkog imanja, one su tako\u0111er idealne za pribli\u017eavanje usluga pacijentima. Kao dio integriranog sistema njege, mobilna infrastruktura, koja je dostupna za niz specijalisti\u010dkih i op\u0107ih procedura, mo\u017ee biti smje\u0161tena u lokalnoj ordinaciji op\u0107e prakse, dru\u0161tvenoj bolnici, stomatolo\u0161koj ordinaciji ili drugoj zdravstvenoj ustanovi.<\/p>\n

Prednosti mobilnih zdravstvenih jedinica u ovom kontekstu su jasne. Njihova fleksibilna i preme\u0161tava priroda zna\u010di da neke vrste mobilnih jedinica ve\u0107 igraju va\u017enu ulogu u pru\u017eanju usluga pacijentima u zajednici. Mobilna infrastruktura mo\u017ee se razvijati i mijenjati kako se potrebe mijenjaju i mo\u017ee se brzo prilagoditi da odgovori na hitne slu\u010dajeve.<\/p>\n

Pru\u017eanje zdravstvene za\u0161tite u zajednici<\/strong><\/p>\n

Da bi se pru\u017eila integrisana nega, neophodno je usvojiti celokupnu sistemsku perspektivu. Vitalna komponenta fleksibilnog i otpornog sistema zdravstvene za\u0161tite je sposobnost udru\u017eivanja resursa na \u0161irem podru\u010dju, omogu\u0107avaju\u0107i pru\u017eanje usluga kada i gdje su najpotrebnije. Ovo je oduvek bilo ta\u010dno, ali pandemija Covid-19 pove\u0107ala je potrebu za sna\u017enim integrisanim sistemima nege, a to se ne mo\u017ee dogoditi osim ako nemamo dovoljno fleksibilno imanje da zadovolji \u0161irok opseg potreba ICS-a.<\/p>\n

Klju\u010d za funkcioniranje ovog pristupa je razvoj kolaborativnih mre\u017ea, jer je nova dijagnosti\u010dka oprema kao \u0161to su skeneri i endoskopi skupa, a kori\u0161tenje svakog novog objekta morat \u0107e se maksimalno pove\u0107ati. Iz prakti\u010dnih i financijskih razloga, postojat \u0107e ograni\u010den broj lokacija na kojima se mo\u017ee smjestiti MRI skener ili endoskopska ustanova, \u0161to zna\u010di da \u0107e mnogi pacijenti i dalje morati putovati na odre\u0111enu udaljenost do centralne lokacije.<\/p>\n

Uz mobilnu infrastrukturu, me\u0111utim, ustanova se mo\u017ee premje\u0161tati izme\u0111u lokacija kako bi se pru\u017eale usluge bli\u017ee pacijentima. Fleksibilnost koju nude mobilne zdravstvene jedinice zna\u010di da se mo\u017ee stvoriti mre\u017ea unutar koje ustanove primarne zdravstvene za\u0161tite, bolnice u zajednici i druge zdravstvene ustanove dijele centralne dijagnosti\u010dke resurse koriste\u0107i sistem 'hub-and-spoke'.<\/p>\n

Ovo bi se moglo isporu\u010diti kombinacijom prijemnog objekta ili 'priklju\u010dne jedinice' i niza mobilnih zdravstvenih ustanova. Priklju\u010dna jedinica je postavljena sa odgovaraju\u0107im priklju\u010dcima, kao \u0161to su komunalije i spojni hodnici, u pripremi za prijem mobilnog objekta, \u0161to omogu\u0107ava jednostavno i brzo povezivanje mobilnih objekata.<\/p>\n

Takav sistem pru\u017ea provajderima skoro trenutni pristup potpuno opremljenim dijagnosti\u010dkim objektima. Mobilni objekti se tada mogu lako premje\u0161tati unutar mre\u017ee i brzo instalirati na drugoj lokaciji. Unutar kolaborativne mre\u017ee mo\u017ee se odabrati niz klini\u010dkih usluga koje odgovaraju potra\u017enji i potrebama zdravstvene za\u0161tite u lokalnom podru\u010dju ili nude razli\u010dite specijalisti\u010dke ustanove na rotaciji.<\/p>\n

Me\u0111u klju\u010dnim prednostima pove\u0107anja pristupa uslugama koriste\u0107i fleksibilnu infrastrukturu je to \u0161to pru\u017ea niskorizi\u010dno i manje kapitalno intenzivno rje\u0161enje, sa fleksibilnim strukturama cijena. Tako\u0111e nudi nizak operativni rizik, jer se za odr\u017eavanje i popravke brine dobavlja\u010d objekta. Uz ovakvo fleksibilno rje\u0161enje, tro\u0161kovi ugovaranja, osoblja i opremanja objekta, kao i njegove pogodnosti, mogli bi se podijeliti izme\u0111u pru\u017eatelja usluga.<\/p>\n

Alternativno, mobilne i modularne jedinice mogu se kombinirati kako bi se stvorilo samostalno fiksno dijagnosti\u010dko \u010dvori\u0161te u gotovo svakom rasporedu, koje sadr\u017ei \u010dekaonice za pacijente, sobe za konsultacije, sobe za skeniranje i procedure, svu specijaliziranu opremu, odjele za oporavak, te osoblje i objekte za pacijente.<\/p>\n

Rje\u0161enje usmjereno na pacijenta<\/strong><\/p>\n

Kona\u010dno, cilj reforme, kao \u0161to je navedeno u izvje\u0161taju NHS-a, je smanjiti i akutna i elektivna vremena \u010dekanja i pomo\u0107i u pobolj\u0161anju ishoda pacijenata. Me\u0111utim, za realizaciju plana trebat \u0107e vrijeme i za postizanje klju\u010dnih ciljeva, uklju\u010duju\u0107i ranu dijagnozu pacijenata oboljelih od raka, hitno je potrebno rje\u0161enje.<\/p>\n

Kori\u0161tenje partnerskog pristupa i obezbje\u0111ivanje kapaciteta od pru\u017ealaca usluga koji mogu podr\u017eati i raditi sa zdravstvenim sistemom mo\u017ee donijeti zna\u010dajne koristi. Ve\u0107 postoje rje\u0161enja koja se mogu implementirati bez potrebe da se \u010deka da se specijalisti obu\u010de i regrutiraju, da se odobre kapitalni bud\u017eeti, da se izvr\u0161i velika kupovina opreme i da se izgrade zgrade, \u0161to zna\u010di da se koristi mogu mnogo br\u017ee prenijeti na pacijente.<\/p>\n

Kako ICS-ovi ubrzavaju svoju evoluciju u narednim godinama, fleksibilna zdravstvena infrastruktura \u0107e igrati sve va\u017eniju ulogu u pobolj\u0161anju pristupa\u010dnosti dijagnosti\u010dkih usluga. Pored pobolj\u0161anja iskustva pacijenata, pove\u0107anje pristupa uslugama na lokalnom nivou mo\u017ee tako\u0111e podsta\u0107i prihvatanje skrininga i dijagnosti\u010dkih procedura. A ako nastavimo da vidimo da klini\u010dari pojednostavljuju upu\u0107ivanje i koriste virtuelne konsultacije na sli\u010dnom nivou kao sada u doglednoj budu\u0107nosti, ove prednosti \u0107e se vremenom samo pove\u0107avati.<\/p>\n

Ovaj se \u010dlanak prvi put pojavio u \u010detvrtom izdanju <\/em>Hospital Times<\/em><\/a> \u010dasopis. <\/em><\/p>","protected":false},"excerpt":{"rendered":"

Potreba za reformom dijagnostike i odvajanjem puteva izme\u0111u akutne i elektivne njege istaknuta je u izvje\u0161taju koji je objavio NHS Engleska u listopadu, a koji je slijedio dugoro\u010dni plan.<\/p>","protected":false},"author":1,"featured_media":1354,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,115],"tags":[131,137,5],"class_list":["post-3621","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-products-and-services","tag-endoscope-decontamination","tag-endoscopy-suite","tag-mobile"],"acf":[],"yoast_head":"\nMaking diagnostic services more accessible - Vanguard Healthcare Solutions<\/title>\n<meta name=\"description\" content=\"A need for reforming diagnostic services and the separation of pathways between acute and elective care was outlined in NHS England report\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.vanguardhealthcare.co.uk\/bs_ba\/making-diagnostic-services-more-accessible\/\" \/>\n<meta property=\"og:locale\" content=\"bs_BA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Making diagnostic services more accessible - 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