Arling Priscilla A, Abrahamson Kathleen, Miech Edward J, Inui Thomas S, Arling Greg
College of Business, Butler University, Indianapolis, Indiana, USA.
Nurs Health Sci. 2014 Sep;16(3):291-7. doi: 10.1111/nhs.12098. Epub 2013 Nov 21.
In this study, we explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. Survey and interview data were collected from nursing home clinicians participating in a quality-improvement collaborative. Quality-improvement outcomes were evaluated using US Federal and State minimum dataset measures. Models were specified evaluating the relationships between resident outcomes, staff perceptions of communication patterns, and staff perceptions of collaborative effectiveness. Interview data provided deeper understanding of the quantitative findings. Reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings, and where respondents perceived that the collaborative kept them informed and provided new ideas. Clinicians observed that participation in a quality-improvement collaborative positively influenced the ability to share innovative ideas and expand the quality-improvement program within their nursing home. For practitioners, a high level of communication, both inside and outside of meetings, was key to making measurable gains in resident health outcomes.
在本研究中，我们探讨了疗养院临床医生质量改进协作组中居民健康结果变化、从业者沟通模式以及从业者对团队有效性的认知之间的关系。我们从参与质量改进协作组的疗养院临床医生处收集了调查和访谈数据。使用美国联邦和州最低数据集指标对质量改进结果进行评估。构建模型以评估居民结果、工作人员对沟通模式的认知以及工作人员对协作有效性的认知之间的关系。访谈数据使我们对定量研究结果有了更深入的理解。在受访者与协作成员在预定会议之外的沟通水平最高，且受访者认为协作组能让他们了解情况并提供新想法的机构中，跌倒率的降低幅度最大。临床医生观察到，参与质量改进协作组对在疗养院内部分享创新想法和扩展质量改进项目的能力产生了积极影响。对于从业者而言，会议内外的高水平沟通是在居民健康结果方面取得可衡量进展的关键。
