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使用基于小组的方法评估欧洲初级保健中的组织发展:成熟度矩阵的可行性研究

Assessing organisational development in European primary care using a group-based method: a feasibility study of the Maturity Matrix.

作者信息

Edwards Adrian, Rhydderch Melody, Engels Yvonne, Campbell Stephen, Vodopivec-Jamsek Vlasta, Marshall Martin, Grol Richard, Elwyn Glyn

机构信息

Department of Primary Care and Public Health, School of Medicine, Cardiff University, UK.

出版信息

Int J Health Care Qual Assur. 2010;23(1):8-21. doi: 10.1108/09526861011010640.

Abstract

PURPOSE

The Maturity Matrix is a tool designed in the U.K. to assess family practice organisational development and to stimulate quality improvement. It is practice-led, formative and undertaken by a practice team with the help of trained facilitators. The aim of this study is to assess the Maturity Matrix as a tool and an organisational development measure in European family practice settings.

DESIGN/METHODOLOGY/APPROACH: Using a convenience sample of 153 practices and 11 facilitators based in the U.K., Germany, The Netherlands, Switzerland and Slovenia, feasibility was assessed against six criteria: completion; coverage; distribution; scaling; translation; and missing data. Information sources were responses to evaluation questionnaires by facilitators and completed Maturity Matrix profiles.

FINDINGS

All practices taking part completed the Maturity Matrix sessions successfully. The Netherlands, the U.K. and Germany site staff suggested including additional dimensions: interface between primary and secondary care; access; and management of expendable materials. Maturity Matrix scores were normally distributed in each country. Scaling properties, translation and missing data suggested that the following dimensions are most robust across the participating countries: clinical performance audit; prescribing; meetings; and continuing professional development. Practice size did not make a significant difference to the Maturity Matrix profile scores.

ORIGINALITY/VALUE: The study suggests that the Maturity Matrix is a feasible and valuable tool, helping practices to review organisational development as it relates to healthcare quality. Future research should focus on developing dimensions that are generic across European primary care settings.

摘要

目的

成熟度矩阵是英国设计的一种工具,用于评估家庭医疗组织发展并促进质量改进。它由实践主导,具有形成性,由实践团队在经过培训的协调员帮助下开展。本研究的目的是评估成熟度矩阵作为欧洲家庭医疗环境中的一种工具和组织发展措施的情况。

设计/方法/途径:利用来自英国、德国、荷兰、瑞士和斯洛文尼亚的153个医疗机构和11名协调员的便利样本,根据六个标准评估可行性:完成情况;覆盖范围;分布;量表;翻译;以及缺失数据。信息来源是协调员对评估问卷的回复以及完整的成熟度矩阵概况。

结果

所有参与的医疗机构都成功完成了成熟度矩阵会议。荷兰、英国和德国的现场工作人员建议增加其他维度:初级和二级医疗之间的接口;可及性;以及消耗品管理。成熟度矩阵得分在每个国家呈正态分布。量表属性、翻译和缺失数据表明,在参与的国家中,以下维度最为稳健:临床绩效审计;处方;会议;以及继续职业发展。医疗机构规模对成熟度矩阵概况得分没有显著影响。

原创性/价值:该研究表明,成熟度矩阵是一种可行且有价值的工具,有助于医疗机构审视与医疗质量相关的组织发展。未来的研究应侧重于开发适用于欧洲初级医疗环境的通用维度。

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