Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Ontario, Canada.
J Interprof Care. 2010 Nov;24(6):653-65. doi: 10.3109/13561820903550697.
Primary care reform involving interprofessional team-based care is a global phenomenon. In Ontario, Canada, 150 Family Health Teams (FHTs) have been approved in the past few years. The transition to a FHT is complex involving many changes and the processes for collaborative teamwork are not clearly delineated. To support the transition to team-based care in FHTs, a project was undertaken to develop and implement a series of interprofessional protocols in four clinical areas. These interprofessional protocols would contain relevant and evidence-based resources to support both a team and evidence-based approach to care. This paper reports on a qualitative study to examine the process of interprofessional protocol development and pilot implementation. Adopting an exploratory case study approach (Robson, 2002 ), 36 interviews were conducted with health professionals and community group members who participated in the creation and piloting of the protocols, and with project managers. In addition, observational and documentary data were gathered on the protocol development and implementation processes. The findings from the protocol development stage demonstrate the value of the focus on evidence and team, the process of assessing and targeting FHT needs, inter-organizational and interprofessional sharing, the importance of facilitation and support, and expectations for implementation. The findings from the pilot implementation stage report on the importance of champions and leaders, the implementation strategies used, FHT and organizational factors affecting implementation, and outcomes achieved. Findings are discussed in relation to the knowledge translation and interprofessional literature. Research is ongoing to examine the effectiveness of dissemination of the protocols to FHTs across the province of Ontario and its impact on health care outcomes.
初级保健改革涉及多专业团队合作是一个全球性现象。在加拿大安大略省，在过去几年中已经批准了 150 个家庭健康团队（FHT）。向 FHT 的过渡是复杂的，涉及许多变化，并且协作团队的流程没有明确界定。为了支持 FHT 中基于团队的护理的过渡，开展了一个项目来开发和实施四个临床领域的一系列多专业协议。这些多专业协议将包含相关的循证资源，以支持团队和循证护理方法。本文报告了一项定性研究，以检查多专业协议开发和试点实施的过程。采用探索性案例研究方法（Robson，2002），对参与协议制定和试点的卫生专业人员和社区团体成员以及项目经理进行了 36 次访谈。此外，还收集了关于协议开发和实施过程的观察和文件数据。从协议制定阶段得出的结论表明了关注证据和团队、评估和确定 FHT 需求、组织间和专业间共享、促进和支持的重要性以及实施的期望的价值。试点实施阶段的结果报告了拥护者和领导者的重要性、使用的实施策略、影响实施的 FHT 和组织因素以及取得的成果。研究结果与知识转化和多专业文献进行了讨论。正在进行研究，以检查将协议传播到安大略省全省的 FHT 及其对医疗保健结果的影响的有效性。
