协作治理在将国家癌症计划转化为基于网络的实践中的作用:加拿大的纵向案例研究
Dominique Tremblay1, Susan Usher2, Karine Bilodeau3
1Full professor, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Canada.
Journal of health services research & policy
|November 16, 2024
概括
癌症网络的目标是综合护理,但面临着挑战. 协作治理机制是关键的,但网络集成中的紧张局势可能会阻碍实现共同目标和以患者为中心的护理的进展.
科学领域:
- 医疗服务研究 医疗服务研究
- 组织研究是组织研究.
- 公共卫生政策 公共卫生政策
背景情况:
- 国家癌症计划越来越多地利用网络进行协调护理.
- 有限的经验证据表明这些网络如何克服专业的域内孤岛.
- 了解协作治理对于有效的基于网络的癌症护理至关重要.
研究的目的:
- 检查国家癌症网络中协作治理的形成.
- 评估治理如何支持综合,基于网络的实践.
- 识别癌症护理提供协作治理的促进者和障碍者.
主要方法:
- 北克癌症网络 (2018-2020年) 的长度定性单一病例研究.
- 通过半结构面试 (n=37) 和文档分析 (n=45) 收集数据.
- 使用爱默生协作治理框架进行抽象主题分析.
主要成果:
- 通过委员会和实践社区培养原则性参与,增强信任和承认相互依赖.
- 共享动机得到了患者为中心的愿景的支持,但受到自上而下的沟通的限制;信任和候选问题影响了提供者之间的合作.
- 联合行动能力受到机构安排和共同指标的影响,尽管有效性问题减少了他们的影响.
结论:
- 尽管有支持性的国家计划,但整合紧张局势阻碍了向协作实践过渡.
- 代地解决这些紧张局势对于开发可接受的治理模型至关重要.
- 有效的协作治理需要驾网络集成的复杂性,以改善癌症护理.
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