当代的质量挑战,混合的一般实践一个多站点纵向案例研究
Rebecca Payne1, Francesca Dakin1, Ellen MacIver1
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
概括
英国的全科医生面临着通过混合模式维持护理质量的挑战. 数字化和效率措施有可能使护理变得不人道,影响可访问性,以患者为中心和公平.
科学领域:
- 一般实践一般实践
- 医疗保健的质量 医疗保健的质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在2022年之后,英国的全科医院将转向混合护理模式 (远程,数字,面对面).
- 这一转型旨在在COVID-19的急性阶段后恢复服务.
研究的目的:
- 检查质量领域在当代英国一般实践中是如何解决的.
- 识别混合护理模式的挑战和意外后果.
主要方法:
- 多站点,定性纵向案例研究设计.
- 数据收集包括民族学研究,研讨会,采访,患者调查和公共数据 (2021-2023).
- 使用多种质量理论进行专题编码和分析.
主要成果:
- 质量努力受到紧缩政策,劳动力分散和基础设施不足的影响.
- 混合模型努力提供基于关系的护理,导致非人性化.
- 效率系统损害了可访问性,以患者为中心和公平性;员工受到压力.
结论:
- 当代杂交的通用医疗实践具有非人性化和分散护理的意外后果.
- 需要紧急的政策和实践干预,以应对风险和保护核心价值观.
- 数字化和协议化需要谨慎管理,以避免损害护理质量.
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