在一般实践中采用量身定制的跨专业协议:从CFIR指导的定性研究中学习的障碍,策略和经验教训
Laurent Desmet1, Eva Goossens2,3,4, Peter Van Bogaert1
1Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium.
在初级保健中实施实践定制的协议可以加强专业间的合作. 成功取决于清晰的沟通,团队协调,以及解决医疗服务提供者的阻力,以改善护理协调.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗服务管理 医疗服务管理
- 实施科学 实施科学
背景情况:
- 新兴的非传染性疾病对初级保健的质量和工作量构成了挑战.
- 具有量身定制的协议的专业间护理模型可以优化任务转移和协调.
- 过渡到基于协议的专业间护理是复杂的,需要进一步研究.
研究的目的:
- 探索一般实践在制定和实施实践定制协议方面的经验.
- 通过实施研究综合框架 (CFIR) 确定跨专业护理过渡的障碍,促进者和战略.
主要方法:
- 在比利时弗兰德斯进行的定性研究.
- 半结构面试与33个医疗保健提供者从18个一般实践.
- 混合定性分析 (以CFIR为指导的感应主题和演).
主要成果:
- 清晰的任务分配和协议中的沟通改善了护理协调.
- 外部因素 (资金,工作量) 是挑战;外部协作是促进者.
- 内部动态 (共同的愿景,信任,会议) 和逐步实施是关键的推动因素.
- 提供者的动机有所不同;一些医生由于关系/案件负担的担忧而抵制.
结论:
- 基于协议的专业间护理是初级保健的必要演变.
- 成功需要有结构的实施,实践管理和团队协调.
- 解决信任和供应商阻力对于广泛采用至关重要.
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