为家庭医生提供同行辅导,以缩小意向采取行动的差距
Tara Kiran1, Kimberly Devotta2, Laura Desveaux2
1From the Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (TK, NR, KW, MLA, MD, JR, NI); Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (TK, NR, KW, MLA, MD, JR); MAP Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada (TK, KD); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (TK, LD, NI); Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada (LD); Women's College Hospital Research Institute, Toronto, Ontario, Canada (KD, LD, NI); Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (KD). tara.kiran@utoronto.ca.
同行指导支持家庭医生使用临床数据以提高质量. 这种可行的方法提高了对实践变革的信心,尽管更广泛的系统问题可能会限制影响.
科学领域:
- 主要护理医学 医疗保健
- 健康 专业 教育 卫生 专业 教育
- 提高质量 提高科学 提高质量
背景情况:
- 同行指导对家庭医生改善临床绩效反有前途.
- 很少有同行辅导质量改进 (QI) 计划在初级保健机构中得到实施和评估.
- 这项研究探讨了同行辅导计划的潜力,以提高家庭医生使用临床绩效数据的智商.
研究的目的:
- 为家庭医生设计,实施和评估同行辅导计划.
- 评估同行指导在初级保健机构中的可行性和可接受性.
- 探索同行辅导如何影响使用临床绩效数据以提高质量.
主要方法:
- 十位同行教练使用基于证据的便利反模型接受培训.
- 数据通过调查,教练焦点小组和与教练医生 (coachees) 的采访收集.
- 诱导反射主题分析用于分析定性和定量数据.
主要成果:
- 25名家庭医生接受了为期3个月的培训;大多数人希望更多的会议,并对改变实践感到自信.
- 辅导方法,强调同情心,被认为是可以接受的.
- 教练协助数据解释,情绪反应,问责制和解决问题,从而实现多种QI目标.
结论:
- 同行指导是一种可行的方法,以支持家庭医生在数据驱动的学习和实践改进.
- 需要进行进一步的研究,以确定同行指导对实践结果和医生福祉的影响.
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