转变为一个以患者为中心的医疗中心在一个城市原住民社区控制的卫生服务:使用规范化过程理论的定性研究
Anton Clifford-Motopi1,2, Karen Gardner3, Renee Brown Nununccal1
1The Institute for Urban Indigenous Health Ltd, Windsor, Queensland, Australia.
Journal of evaluation in clinical practice
|December 11, 2024
概括
这项研究探讨了在城市原住民社区控制卫生服务 (ACCHS) 中实施以患者为中心的医疗家庭 (PCMH) 模式. 现有的实践规范促进了PCMH的采用,而资源和角色定义问题阻碍了它.
科学领域:
- 初级医疗保健是一项主要的医疗保健服务.
- 土著健康土著健康
- 医疗服务提供 医疗服务提供
背景情况:
- 以患者为中心的医疗中心 (PCMH) 是一个以团队为基础,以患者为中心,协调,可访问,质量和安全为重点的护理模式.
- 本研究调查了在澳大利亚的城市原住民社区控制卫生服务 (ACCHS) 中实施适应的PCMH模型.
- 使用规范化过程理论 (NPT) 来了解PCMH实施的促进因素和障碍以及相关的工作负载.
研究的目的:
- 检查在ACCHS环境中实施PCMH的推动因素和障碍.
- 确定加强PCMH模型的实施和持续交付的实际策略.
主要方法:
- 半结构面试对19名城市ACCHS的卫生工作人员进行了半结构面试.
- 专题分析用于分析采访数据,将代码与NPT构造 (一致性,认知参与,集体行动,反思性评估) 进行映射.
主要成果:
- 确定了与NPT构造相关的5个关键主题和14个子主题.
- 卫生工作人员认为PCMH模型是连贯的,并积极参与调整角色和嵌入新实践.
- 现有的临床特征和实践规范与PCMH模型保持一致,作为关键推动者;然而,资源不足和定义不良的角色构成了障碍.
结论:
- 该研究发现,土著社区控制的医疗保健机构的固有特征和实践规范是PCMH实施的重要推动因素.
- 低于最佳的资源和劳动力发展被确定为需要解决的关键障碍,以加强PCMH在ACCHS环境中的实施和交付.
相关概念视频
01:30Community Based Intervention
33
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
33
01:29Documentation in Long-Term and Home Healthcare Setting
873
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
873
01:30Primary Healthcare Services
1.3K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.3K
01:26Methods Of Healthcare Delivery System
3.2K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.2K
01:15Methods of Documentation VI: Case Management Model
559
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
559
01:13Patient-centered Care
2.0K
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
2.0K