在家庭医生签约服务团队中应用TeamSTEPPS对糖尿病管理的效果评估

Application of TeamSTEPPS in training community diabetes management team

2017年1—5月选取已与家庭医生"1+1+1"签约并团队管理1年以上的糖尿病患者150例,由经过利用提高医疗质量和患者安全的团队策略与工具包(TeamSTEPPS)培训的社区糖尿病全科管理团队,继续进行综合管理1年,比较团队接受TeamSTEPPS培训前后对糖尿病患者的管理效果。TeamSTEPPS培训后,糖尿病患者遵医嘱服药、定期检测血糖、定期随访评估、参加健康教育讲座、规律运动、饮食控制的依从性均较前升高,差异有统计学意义(均P<0.01);患者空腹血糖、餐后2 h血糖、糖化血红蛋白、LDL-C水平均较前下降,各指标达标率也较前升高,差异有统计学意义(均P<0.05)。提示,利用TeamSTEPPS培训的社区糖尿病团队管理模式,可有效提高社区家庭医生慢病管理团队的服务能力,改善糖尿病患者的依从性和临床指标。

One hundred and fifty diabetic patients, who received management by community family doctors and hospital consortium (1+1+1) team for at least 1 year, were enrolled from January 2017 to May 2017. After that they continued to receive the management for 1 more year by the team which were trained with TeamSTEPPS (team strategies and tools to enhance performance and patient safety). The management effect before and after TeamSTEPPS training was compared. After the TeamSTEPPS training, the team management ability was improved, so that the compliance of diabetic patients with medical advice, regular examination of blood glucose, regular follow-up assessment, health education, regular exercise and diet control were all better than before, and the differences were statistically significant (all P<0.01). Fasting blood glucose, postprandial 2 h-blood glucose, glycosylated hemoglobin and LDL-C levels were all lower than before, and the achieved rate of the above indicators were also increased (P<0.05). It is suggested that application of TeamSTEPPS in team training can effectively enhance the management ability for chronic disease of family doctors and improve compliance and clinical indicators of patients with diabetes under management.