制定初级保健质量改善成功的模型:在农村,城市和Kaupapa Māori组织中的比较案例研究
Jane Cullen1, Paul Childerhouse2, Nihal Jayamaha1
1Massey University, Palmerston North, New Zealand.
Journal of primary health care
|December 19, 2023
概括
初级保健的质量改善受内部团队文化和外部网络的影响. 强大的组织文化和协作型领导力促进了成功的质量改善举措,提高了患者和工作人员的成果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 组织心理学 组织心理学
- 初级医疗保健是一项主要的医疗保健.
背景情况:
- 初级保健面临着压力,需要在有限的资源下提供可访问,公平和优质的医疗保健.
- 了解影响质量改进 (QI) 的因素对于高性能初级保健系统至关重要.
- 有限的研究存在于影响QI的上下文因素,特别是在初级保健机构.
研究的目的:
- 确定影响初级保健中的QI的上下文因素.
- 探索环境,QA倡议和实施之间的关系如何影响结果.
- 为提高初级保健系统绩效提供见解.
主要方法:
- 使用实施研究综合框架进行的定性案例研究.
- 在六个不同的地点 (农村,城市,考帕帕毛利) 深入探索初级保健经验.
- 通过半结构面试,组织文件和参与者数据收集数据.
主要成果:
- 报告了患者,诊所和工作人员的成功结果.
- 强大的内部组织文化 ("Clan", "Adhocracy") 促进了团队合作,分布式领导力和学习气候.
- 外部网络关系提供了不同程度的资源,知识和支持.
结论:
- 组织动机源自患者/社区需求和内部文化.
- 团队合作支持的参与,分布和新兴领导力是关键.
- 一个支持性的学习气候使代的感知和成功的QI实施成为可能.
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