Kvamme O J, Olesen F, Samuelson M
Department of General Practice, University of Oslo, P O Box 24, N-5484 Sabovik, Norway.
Qual Health Care. 2001 Mar;10(1):33-9. doi: 10.1136/qhc.10.1.33.
A group from the European Working Party on Quality in Family Practice (EQuiP), working with over 20 European colleges of primary care, has assessed what, in their view, is needed to improve the quality of care at the interface between general practice and specialists. Experiences and ideas from a wide range of people were gathered through focused group discussions. From these it was clear that, for real improvement at the interface of care, changes are needed in the system of care and in the ways that doctors view their roles and their performance. All providers of care need to be able to see the care system from the patients' perspective if they are to help their patients make sense of and benefit from an increasingly complex system. This paper outlines the EQuiP recommendations on how cooperation between general practitioners and specialists might be improved. This includes strategic perspectives and both targets for improvement and methods for teaching, training and development that are all independent of country and health care system. The 10 targets for development identified by the group are: leadership, initial shared care approaches, task division, mutual guidelines, patient perspective, informatics, education, team building, quality monitoring systems, and cost effectiveness. Working towards these targets could provide an effective approach to improving the cooperation between the interfaces of care. Getting effective leadership is a necessary first step as implementation of such a strategy will involve significant change. Responsibility lies primarily with the medical profession.
欧洲家庭医疗质量工作小组（EQuiP）与20多家欧洲初级保健学院合作，评估了他们认为在改善全科医疗与专科医疗衔接处的医疗质量方面需要做些什么。通过焦点小组讨论收集了广泛人群的经验和想法。从中可以清楚地看出，为了真正改善医疗衔接处的情况，医疗系统以及医生看待其角色和表现的方式都需要改变。如果所有医疗服务提供者想要帮助患者理解并受益于日益复杂的医疗系统，他们就需要能够从患者的角度看待医疗系统。本文概述了EQuiP关于如何改善全科医生与专科医生之间合作的建议。这包括战略视角以及改进目标和教学、培训与发展方法，这些都与国家和医疗保健系统无关。该小组确定的10个发展目标是：领导力、初始共享医疗方法、任务分工、共同指南、患者视角、信息学、教育、团队建设、质量监测系统和成本效益。朝着这些目标努力可以为改善医疗衔接处的合作提供一种有效方法。获得有效的领导力是必要的第一步，因为实施这样一项战略将涉及重大变革。主要责任在于医疗行业。
