Consensus statement on networks for high-quality rural anesthesia, surgery, and obstetric care in Canada

[摘要] Objective To describe the essential components of well-resourced and highfunctioning multidisciplinary networks that support high-quality anesthesia, surgery,and maternity care for rural Canadians, delivered as close to home as possible.Composition of the committee A volunteer Writers’ Group was drawn fromthe Society of Obstetricians and Gynaecologists of Canada, the Society of RuralPhysicians of Canada, the Royal College of Physicians and Surgeons of Canada,the Canadian Association of General Surgeons, the College of Family Physicians ofCanada, and the Association of Canadian University Departments of Anesthesia.Methods A collaborative effort over the past several years among theprofessional stakeholders has culminated in this consensus statement onnetworked care designed to integrate and support a specialist and nonspecialist, urban and rural, anesthesia, surgery, and maternity work forceinto high-functioning networks based on the best available evidence.Report Surgical and maternity triage needs to be embedded within networksto address the tensions between sustainable regional programs and localaccess to care. Safety and quality must be demonstrated to be equivalentacross similar patients and procedures, regardless of network site. Triage ofpatients across multiple sites is a quality outcome metric requiring continuousiterative scrutiny. Clinical coaching between rural and regional centres can behelpful in building and sustaining high-functioning networks. Maintenanceof quality and the provision of continuing professional development in lowvolume settings represent a mutual value proposition.Conclusion The trusting relationships that are foundational to successfulnetworks are built through clinical coaching, continuing professionaldevelopment, and quality improvement. Currently, a collaborative effort inBritish Columbia is delivering a provincial program—Rural Surgical ObstetricalNetworks—built on the principles and supporting evidence described in thisconsensus statement.

[学科分类] 卫生学