Kelly Diane R, Lough Murray, Rushmer Rosemary, Wilkinson Joyce E, Greig Gail, Davies Huw T O
NHS Education for Scotland, West of Scotland Region, Glasgow, UK.
J Eval Clin Pract. 2007 Oct;13(5):734-40. doi: 10.1111/j.1365-2753.2006.00746.x.
RATIONALE, AIMS AND OBJECTIVES: Learning is recognized to be at the heart of the quality improvement process in the National Health Service (NHS). However, the challenge will be how to ensure that learning becomes embedded within the NHS culture. The aim of this study is to identify a robust feedback process and format in which practices could receive data on their responses to a Learning Practice Inventory (a diagnostic instrument designed to identify a practice's capacity for collective learning and change).
Five practices volunteered to test the instrument, and it was distributed to all members of the primary care team. A process was worked through to identify different formats for presenting scores within and between practices. The preferred method of data presentation was sought, and an evaluation gathered information on the preferred form of feedback, the usefulness of the data, the clarity of the questions and the level of interest in receiving further information.
Eighty-five staff from five practices completed the questionnaire, and 61 individuals completed the evaluation forms. In most cases, there was a spread of scores by staff within practices and across the scale of 1-10. Medians were clustered at the learning practice end for all five practices. However, despite this skew, there were sometimes quite large differences between practices in their median scores.
Our study suggests that a robust feedback process on collective capacity for learning and change can be identified that is useful and feasible. A key implication is that some form of educational support is required, and this work will take place as part of an ongoing programme of research by the authors.
基本原理、目的和目标:学习被认为是国民医疗服务体系(NHS)质量改进过程的核心。然而,挑战在于如何确保学习融入NHS文化之中。本研究的目的是确定一个强有力的反馈过程和形式,通过这种方式,医疗机构能够收到关于其对学习实践量表(一种用于识别医疗机构集体学习和变革能力的诊断工具)的反馈数据。
五家医疗机构自愿参与测试该工具,并将其分发给基层医疗团队的所有成员。通过一个过程来确定在医疗机构内部和之间呈现分数的不同形式。寻找数据呈现的首选方法,并进行一项评估,收集关于反馈的首选形式、数据的有用性、问题的清晰度以及接收更多信息的兴趣程度等方面的信息。
来自五家医疗机构的85名员工完成了问卷,61人完成了评估表。在大多数情况下,员工在医疗机构内部以及在1至10的量表范围内分数有所分布。所有五家医疗机构的中位数都集中在学习实践一端。然而,尽管存在这种偏差,但各医疗机构的中位数分数有时仍存在相当大的差异。
我们的研究表明,可以确定一个关于集体学习和变革能力的强有力的反馈过程,该过程既有用又可行。一个关键的启示是需要某种形式的教育支持,这项工作将作为作者正在进行的研究项目的一部分开展。