Walsh N, Huntington J
Health Services Management Centre, University of Birmingham, Birmingham, UK.
Health Serv Manage Res. 2003 Nov;16(4):251-60. doi: 10.1258/095148403322488946.
This paper describes findings from an exploratory study of attempts by primary care clinicians and managers to utilize two distinct Government policy initiatives (the establishment of Primary Care Groups [PCGs] and Trusts [PCTs] and the establishment of Primary Medical Services [PMS] pilots) to promote innovation in primary care. The study purposively selected three whole PCG-PMS sites and one PCT-PMS site. A range of different qualitative methods were used to collect data. Although the data suggest that attempts to integrate the two policies produced impressive corporate innovation by practices working together to benefit patients in whole localities, the four sites shared features that would not necessarily be present in all PCG/Ts. These include a strong history of inter-practice working, mutually supportive relationships between clinicians and managers, and a carefully designed, managed and inclusive change process led by credible clinicians. The study has implications for the continuing implementation of both policies, especially in view of the increasing size of PCTs.
本文描述了一项探索性研究的结果，该研究探讨了基层医疗临床医生和管理人员利用两项不同的政府政策举措（建立初级保健小组[PCG]和初级保健信托基金[PCT]以及开展初级医疗服务[PMS]试点）来促进基层医疗创新的尝试。该研究有目的地选择了三个完整的PCG-PMS站点和一个PCT-PMS站点。使用了一系列不同的定性方法来收集数据。尽管数据表明，整合这两项政策的尝试通过各机构共同努力为整个地区的患者谋福利，从而产生了令人印象深刻的机构创新，但这四个站点具有的共同特征不一定会出现在所有的初级保健信托基金（PCT）中。这些特征包括机构间合作的悠久历史、临床医生与管理人员之间相互支持的关系，以及由可靠的临床医生领导的精心设计、管理和包容的变革过程。该研究对这两项政策的持续实施具有启示意义，特别是考虑到初级保健信托基金规模不断扩大的情况。
