Green Michael E, Weir Erica, Hogg William, Etches Vera, Moore Kieran, Hunter Duncan, Birtwhistle Richard
Department of Family Medicine, Queen's University, Kingston, ON, Canada.
Healthc Policy. 2013 Feb;8(3):e93-104.
To identify and explore areas where responsibilities may overlap between family health teams (FHTs) and public health units (PHUs); to identify facilitators or barriers to collaboration; and to identify priority areas for increased collaboration. DESIGN AND CONTEXT: Cross-sectional mixed-methods study of FHTs and PHUs in Ontario, Canada, consisting of a postal survey, key informant interviews and a roundtable meeting.
The survey response rate was 46%. Direct client-based services such as giving immunizations, promoting prenatal health and nutrition, and counselling related to smoking cessation were identified as the top three areas of perceived overlap. The greatest interest in collaboration was expressed in the areas of emergency planning and preparedness, immunization, and prenatal health and nutrition. Good communication with a clear understanding of roles and functions was the most important facilitator, and lack of resources and absence of a clear provincial mandate and direction to collaborate were identified as significant barriers.
Small, simple client-based projects of interest to both kinds of organization would be the best way to move forward in the short term. Improving communication between FHTs and PHUs, understanding of roles and functions, the use of shared or interoperable information systems and greater clarity from government on the ways in which these two key sectors of the healthcare system are intended to work together were identified as important for the success of increased collaboration.
确定并探索家庭健康团队(FHTs)与公共卫生单位(PHUs)之间职责可能重叠的领域;确定合作的促进因素或障碍;并确定加强合作的优先领域。设计与背景:对加拿大安大略省的家庭健康团队和公共卫生单位进行横断面混合方法研究,包括邮政调查、关键信息提供者访谈和一次圆桌会议。
调查回复率为46%。提供免疫接种、促进产前健康和营养以及戒烟咨询等基于直接客户的服务被确定为感知重叠的前三大领域。在应急规划与准备、免疫接种以及产前健康和营养领域,对合作表现出了最大兴趣。良好的沟通以及对角色和职能的清晰理解是最重要的促进因素,而资源匮乏以及缺乏明确的省级合作授权和方向被确定为重大障碍。
短期内,开展两类组织都感兴趣的小型、简单的基于客户的项目将是推进合作的最佳方式。改善家庭健康团队与公共卫生单位之间的沟通、对角色和职能的理解、共享或可互操作信息系统的使用,以及政府更明确地说明医疗保健系统这两个关键部门打算如何共同合作,被认为对加强合作的成功至关重要。