影响实施多方面干预措施的情境因素,以改善住院患者的团队合作和质量:一个多站点的定性比较案例研究
Joint Commission journal on quality and patient safety
|October 14, 2023
概括
重新设计的医院护理模式的成功实施取决于四个关键因素:强有力的领导支持,协调的组织目标,参与的现场领导和医疗保健专业人员感知的好处. 这些要素对于改善患者护理系统至关重要.
科学领域:
- 医疗保健管理的管理
- 提高质量 提高质量
- 医院运营 医院运营
背景情况:
- 医院正在采用综合护理模式,包括医生本地化,护士-医生联合领导和跨专业轮次.
- 了解上下文因素对于成功实施这些新型护理模式至关重要.
研究的目的:
- 识别和分析影响住院医疗患者重新设计护理模式成功实施的上下文因素.
主要方法:
- 在四家参与REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) 研究的医院中进行了一项定性比较案例研究.
- 数据收集包括对40名医疗保健专业人员和4名导师的观察和半结构面试,随后是诱导性的定性内容分析和交叉案例分析.
主要成果:
- 有四个上下文因素与成功实施有关:高级领导层的参与和支持,与组织优先事项的协调,有强有力的关系的参与现场领导,以及专业人员感知到的需求和利益.
- 最佳的实施发生在稳定,参与的高级领导层,一致的目标,致力和合作的现场领导人以及护士和医生对干预措施的积极看法.
结论:
- 四个相互关联的上下文因素对重新设计医疗患者护理的综合干预措施的实施产生重大影响.
- 医院领导人必须在规划和执行类似的护理重新设计计划时考虑这些因素和潜在的挑战.
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