Xie Anping, Carayon Pascale, Cartmill Randi, Li Yaqiong, Cox Elizabeth D, Plotkin Julie A, Kelly Michelle M
Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, WI, USA; Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA.
Appl Ergon. 2015 Jan;46 Pt A:115-23. doi: 10.1016/j.apergo.2014.07.011. Epub 2014 Aug 12.
A human factors approach to healthcare system redesign emphasizes the involvement of multiple healthcare stakeholders (e.g., patients and families, healthcare providers) in the redesign process. This study explores the experience of multiple stakeholders with collaboration in a healthcare system redesign project. Interviews were conducted with ten stakeholder representatives who participated in the redesign of the family-centered rounds process in a pediatric hospital. Qualitative interview data were analyzed using a phenomenological approach. A model of collaborative healthcare system redesign was developed, which defined four phases (i.e., setup of the redesign team, preparation for meetings, collaboration in meetings, follow-up after meetings) and two outcomes (i.e., team outcomes, redesign outcomes) of the collaborative process. Challenges to multi-stakeholder collaboration in healthcare system redesign, such as need to represent all relevant stakeholders, scheduling of meetings and managing different perspectives, were identified.
一种以人因工程学为导向的医疗系统重新设计方法强调多个医疗利益相关者（如患者及其家属、医疗服务提供者）参与重新设计过程。本研究探讨了多个利益相关者在一个医疗系统重新设计项目中的协作经验。对参与一家儿科医院以家庭为中心的查房流程重新设计的十名利益相关者代表进行了访谈。使用现象学方法对定性访谈数据进行了分析。开发了一个协作式医疗系统重新设计模型，该模型定义了协作过程的四个阶段（即重新设计团队的组建、会议准备、会议中的协作、会后跟进）和两个结果（即团队结果、重新设计结果）。确定了医疗系统重新设计中多利益相关者协作面临的挑战，如需要代表所有相关利益者、会议安排以及管理不同观点等。
