基于团队护理的学习协作评估:使用规范化过程理论对辅导电话进行定性分析
Kathleen Thies1, Meaghan Angers2, Amanda Schiessl2
1Weitzman Institute, Community Health Center Inc, Middletown, Connecticut, USA thiesk@mwhs1.com.
BMJ open quality
|August 11, 2025
概括
学习协作 (LC) 需要评估规范化机制,而不仅仅是结果. 规范化过程理论 (NPT) 机制,如连贯性和认知参与,同时工作,而不是线性,以获得成功的实践实施.
科学领域:
- 改善医疗保健 改善医疗保健
- 组织行为 组织行为
- 实施科学 实施科学
背景情况:
- 评估学习协作 (LC) 需要了解团队如何实施和规范化新实践.
- 规范化过程理论 (NPT) 为分析这些实施机制提供了一个框架.
- 基于团队的初级保健实施在医疗保健环境中提出了独特的挑战.
研究的目的:
- 分析在学习协作 (LC) 期间使用规范化过程理论 (NPT) 机制,旨在实施以团队为基础的初级保健.
- 检查参与团队如何使用NPT机制 (连贯性,认知参与,集体行动,反射监测).
- 了解这些规范化机制在实时实践中的时间和并发性质.
主要方法:
- 持续比较编码来自团队教练和导师之间每周通话的成绩单.
- 在为期9个月的学习合作中,对规范化过程理论 (NPT) 机制的分析.
- 包括13个卫生中心实施以团队为基础的初级保健.
主要成果:
- 规范化机制同时运行,递归,并以积极和消极的方式运行,而不是线性运行.
- 目标的清晰度 (凝聚力) 和团队承诺 (认知参与) 随着时间的推移,通过定期会议发展.
- 足够的连贯性和认知参与需要3-4个月;对于一些团队的数据使用反射监测,9个月是不够的.
结论:
- 在学习协作中成功实施新的实践取决于规范化机制的动态相互作用.
- 团队需要时间来建立核心机制,如连贯性和认知参与,然后专注于反射监测.
- 了解NPT机制的非线性,并发性质对于优化医疗保健改进计划至关重要.
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