Faculties of Health Sciences and Information and Media Studies, Western University, London ON, N6A 5B9, Canada. ssibbald@ uwo.ca
J Med Libr Assoc. 2013 Apr;101(2):128-37. doi: 10.3163/1536-5050.101.2.008.
Improving the process of evidence-based practice in primary health care requires an understanding of information exchange among colleagues. This study explored how clinically oriented research knowledge flows through multidisciplinary primary health care teams (PHCTs) and influences clinical decisions.
This was an exploratory mixed-methods study with members of six PHCTs in Ontario, Canada. Quantitative data were collected using a questionnaire and analyzed with social network analysis (SNA) using UCINet. Qualitative data were collected using semi-structured interviews and analyzed with content analysis procedures using NVivo8.
It was found that obtaining research knowledge was perceived to be a shared responsibility among team members, whereas its application in patient care was seen as the responsibility of the team leader, usually the senior physician. PHCT members acknowledged the need for resources for information access, synthesis, interpretation, or management.
Information sharing in interdisciplinary teams is a complex and multifaceted process. Specific interventions need to be improved such as formalizing modes of communication, better organizing knowledge-sharing activities, and improving the active use of allied health professionals. Despite movement toward team-based models, senior physicians are often gatekeepers of uptake of new evidence and changes in practice.
要改进初级卫生保健中的循证实践流程,就必须了解同事之间的信息交流情况。本研究旨在探讨以临床为导向的研究知识如何在多学科初级卫生保健团队(PHCT)中流动,并对临床决策产生影响。
这是一项在加拿大安大略省的 6 个 PHCT 成员中开展的探索性混合方法研究。采用问卷收集定量数据,并使用 UCINet 进行社会网络分析(SNA)进行分析。采用半结构式访谈收集定性数据,并使用 NVivo8 进行内容分析程序进行分析。
研究发现,获取研究知识被认为是团队成员的共同责任,而将其应用于患者护理则被视为团队负责人(通常是资深医生)的责任。PHCT 成员认识到需要资源来获取、综合、解释或管理信息。
跨学科团队中的信息共享是一个复杂且多方面的过程。需要改进具体的干预措施,例如正式沟通模式、更好地组织知识共享活动以及提高辅助卫生专业人员的积极使用。尽管朝着团队为基础的模式发展,但资深医生通常是新证据的采纳和实践变革的把关人。