医疗保健大系统转型的四个系统启动器:混合方法现实主义评估
Emilie Francis-Auton1, Janet C Long1, Mitchell Sarkies1
1Australian Institute of Health Innovation, Macquarie University.
The Milbank quarterly
|December 25, 2023
概括
成功的大规模医疗保健转型需要四个关键的系统启用因素:授权环境,质量数据,分布式领导和学习文化. 这些因素促进了积极的变化,并提高了医疗保健的质量和安全.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理 医疗保健管理
- 公共卫生政策 公共卫生政策
背景情况:
- 大规模的医疗保健计划旨在提高质量,效率和安全.
- 实施和维持这些倡议是复杂和具有挑战性的.
- 本研究确定了指导大规模医疗保健转型的关键系统启用因素.
研究的目的:
- 识别和定义成功的大规模医疗保健转型的系统支持者.
- 提供对影响医疗保健干预成功的因素的细微了解.
- 开发基于价值的医疗保健计划的实施模式的经验基础.
主要方法:
- 对澳大利亚新南威尔士州 (2017-2021) 的基于价值的医疗保健计划进行了一项现实研究.
- 数据来源包括文献评论,文档分析,利益相关者讨论和半结构面试 (n=56).
- 背景机制结果 (CMO) 陈述由专家小组 (n=51) 开发,改进和验证.
主要成果:
- 完善了42个CMO声明,从而确定了四个总体的系统启用因素.
- 四个关键的推动因素是:建立一个授权的环境,提供真实和及时的数据,指定和分配领导力,并培养学习文化.
- 这些支持者提供了对大型系统转型有效的条件的洞察.
结论:
- 系统启用器为实施大规模医疗保健干预提供了关键指导.
- 已识别的启用因素有可能转移到类似的医疗保健环境中.
- 这些发现的应用可以带来更高的质量,更高的价值和更安全的医疗保健服务.
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