从任务到意义:健康公平实施框架和与健康相关的社会需求实施的知识转化为行动的定性研究
Rachel P Zimmer1,2, Camelia Singletary1, Aylin Aguilar3
1Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
实施与健康相关的社会需求 (HRSN) 查需要将系统优先级与前线现实保持一致. 整合社区卫生工作者和改善工作流程是有效实施HRSN和健康公平的关键.
科学领域:
- 实施科学 实施科学
- 健康 公平 研究 健康 公平 研究
- 医疗保健管理的管理
背景情况:
- 与健康相关的社会需求 (HRSN) 对以患者为中心的护理至关重要.
- 医疗保健系统在扩大HRSN查和转诊方面面临挑战.
- 整合HRSN查是强制性的,但很难实施.
研究的目的:
- 探索早期实施HRSN查和转诊.
- 使用HEIF和KTA框架检查多层次障碍和促进者.
- 确定有效的HRSN集成策略.
主要方法:
- 定性描述性研究设计.
- 与23名医疗保健领导者,导航员,临床医生和CHW进行了半结构化采访.
- 专注于领导和实施HRSN查的经验.
主要成果:
- 前线工作人员报告说,工作流程不连接,角色不清楚,沟通缺口.
- 工作人员在没有可用资源的情况下选识别需求时经历了痛苦.
- 社区卫生工作者 (CHWs) 扮演着一个关键的,但缺乏整合的角色.
- 在任务和现实之间存在误差.
- 建议的改进包括培训,参与式设计,CHW集成和适应的协议.
结论:
- 前线工作人员的知识对于稳健的HRSN实施至关重要.
- 将系统优先级与护理提供现实保持一致,对于健康公平至关重要.
- 有效的HRSN查可以成为促进健康公平的有力工具.
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