从自下而上的角度来看,协作和专业的边界挑战:在医院病房内的一项内部行动研究研究
Mia Björk1, Annika Eklund2, Maria Skyvell Nilsson1
1Department of Health Sciences, University West, Trollhättan, Sweden.
Journal of health organization and management
|December 2, 2024
概括
医院的专业间合作面临来自不清楚的专业界限和资源限制的挑战. 重组日常工作改善了团队动态,但遇到了阻力,突出了层次结构的问题.
科学领域:
- 医疗保健管理的管理
- 护理学研究 护理学研究
- 卫生社会学 卫生社会学
背景情况:
- 医院病房经常在专业间的合作中遇到挑战.
- 了解专业界限对于有效的团队合作和患者护理至关重要.
- 一个自下而上的观点是有价值的,用于识别和解决工作场所的问题.
研究的目的:
- 在医院病房内识别和描述协作和专业边界挑战.
- 从医疗保健专业人员的角度探索这些挑战.
- 为改善专业间合作的战略提供信息.
主要方法:
- 在瑞典西部的一家医院病房中采用了内部行动研究 (IAR) 方法.
- 利用文化历史活动理论 (CHAT) 作为理论框架.
- 通过在2019年至2021年期间进行的改进项目收集数据.
主要成果:
- 不明确的专业界限和有限的资源严重阻碍了专业间的合作.
- 每日工作的重组是必要的,以与不同的职业责任和患者康复需求保持一致.
- 关于职业角色,界限和道德的公开沟通对于安全的患者出院至关重要.
结论:
- 修改每日团队周围的日常工作提高了助理护士的地位,并鼓励医生包容性.
- 该倡议面临临临床领导层的阻力,他们担心对患者逗留时间的潜在影响.
- 在医院中修改等级结构和既定的社会秩序带来了重大挑战.
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