Tham Rachel, Buykx Penny, Kinsman Leigh, Ward Bernadette, Humphreys John S, Asaid Adel, Tuohey Kathy, Jenner Rohan
School of Rural Health, Monash University, PO Box 666, Bendigo, Vic. 3552, Australia. Email: ; ; ;
Centre of Research Excellence in Rural and Remote Primary Health Care, Monash University, Bendigo, Vic. 3552, Australia.
Aust Health Rev. 2014 Nov;38(5):580-3. doi: 10.1071/AH14015.
Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victoria, were surveyed. Qualitative methods were used to collect data to show how the key factors associated with the evolution of a once-struggling medical service into a successful and sustainable PHC service have influenced staff satisfaction. The success of the service was linked to visionary leadership, teamwork and community involvement while service sustainability was described in terms of inter-professional linkages and the role of the service in contributing to the broader community. These factors were reported to have a positive impact on staff satisfaction. The contribution of service delivery change and ongoing service sustainability to staff satisfaction in this rural setting has implications for planning service change in other primary health care settings. WHAT IS KNOWN ABOUT THIS TOPIC?: Integrated PHC services have an important role to play in achieving equitable population health outcomes. Many rural communities struggle to maintain viable PHC services. Innovative PHC models are needed to ensure equitable access to care and reduce the health differential between rural and metropolitan people. WHAT DOES THIS PAPER ADD?: Multidisciplinary teams, visionary leadership, strong community engagement combined with service partnerships are important factors in the building of a rural PHC service that substantially contributes to enhanced staff satisfaction and service sustainability. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS?: Understanding and engaging local community members is a key driver in the success of service delivery changes in rural PHC services.
强大的基层医疗保健（PHC）服务高效、具有成本效益，且与更好的人群健康结果相关。然而，对于基层医疗保健工作人员在创建可持续服务中的作用和观点却知之甚少。对维多利亚州西北部一个小乡村社区埃尔莫尔的单点式基层医疗服务机构的工作人员进行了调查。采用定性方法收集数据，以展示与一项曾经举步维艰的医疗服务发展成为成功且可持续的基层医疗保健服务相关的关键因素如何影响工作人员的满意度。该服务的成功与有远见的领导、团队合作和社区参与相关，而服务的可持续性则体现在跨专业联系以及该服务对更广泛社区的贡献作用方面。据报告，这些因素对工作人员满意度有积极影响。在这种农村环境中，服务提供变革和持续的服务可持续性对工作人员满意度的贡献，对于规划其他基层医疗保健环境中的服务变革具有启示意义。关于该主题已知的情况：综合基层医疗保健服务在实现公平的人群健康结果方面可发挥重要作用。许多农村社区难以维持可行的基层医疗保健服务。需要创新的基层医疗保健模式来确保公平获得医疗服务，并缩小农村和城市人群之间的健康差距。本文补充了什么内容：多学科团队、有远见的领导、强大的社区参与以及服务伙伴关系是构建农村基层医疗保健服务的重要因素，这对提高工作人员满意度和服务可持续性有很大贡献。对从业者有何启示：理解并让当地社区成员参与是农村基层医疗保健服务中服务提供变革成功的关键驱动力。
