实施中国强制性抗微生物管理计划:持续改进的障碍
Xiaomin Wang1, Leesa Lin2,3,4, Xin Xu5
1School of Public Administration, Hangzhou Normal University, No. 2318 Yuhangtang Road, Yuhang District, Hangzhou 311121, China.
中国的强制性抗微生物管理 (AMS) 计划显示出共同的策略,但导致了意想不到的后果. 主要障碍包括沟通不良和以利为导向的系统,阻碍有效的AMS实施.
科学领域:
- 医疗保健管理的管理
- 传染病控制和控制传染病
- 公共卫生政策 公共卫生政策
背景情况:
- 抗微生物耐药性需要强大的抗微生物管理 (AMS) 计划.
- 中国的医疗保健系统在实施强制性AMS计划方面面临着独特的挑战.
研究的目的:
- 调查中国强制性AMS计划的实施策略.
- 识别与这些计划相关的意外后果和障碍.
- 为改善AMS计划有效性提供建议.
主要方法:
- 采用面对面,深度采访的定性研究.
- 在中国各个地区的16家公立医院采访了111名受访者.
- 用于分析面试数据的专题框架分析.
主要成果:
- 一个共同的实施策略涉及医院领导,授权AMS团队,并设定绩效指标.
- 意想不到的后果包括规范规避,将风险转移到临床医生和患者身上,以及医疗保健工作者的动机下降.
- 主要障碍是AMS团队与医生之间的沟通不良以及以利为导向的薪酬制度.
结论:
- 强制性AMS计划需要加强培训,改善沟通和调整补偿系统.
- 解决权力动态和财务激励对于成功实施AMS至关重要.
- 需要采取支持性措施,以促进采用严格的AMS法规.
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