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质量改进、患者安全和继续教育:当前这些领域合作的边界和机会的定性研究。

Quality improvement, patient safety, and continuing education: a qualitative study of the current boundaries and opportunities for collaboration between these domains.

机构信息

Dr. Kitto is associate professor, Department of Innovation in Medical Education, and director of research, Office of Continuing Professional Development, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Dr. Goldman is research associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Etchells is associate professor, Department of Medicine, Faculty of Medicine, University of Toronto, and medical director of information services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Dr. Silver is vice president of education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Ms. Peller was research associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, at the time this study was done. Dr. Sargeant is professor and head, Division of Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. Dr. Reeves is professor in interprofessional research, Faculty of Health, Social Care, and Education, Kingston University/St. George's, University of London, London, England. Dr. Bell is associate professor, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

Acad Med. 2015 Feb;90(2):240-5. doi: 10.1097/ACM.0000000000000596.

Abstract

PURPOSE

Quality improvement/patient safety (QI/PS) and continuing education (CE) efforts have a common aim to improve health care outcomes. Yet, minimal collaboration occurs between them. This lack of integration can be problematic given the finite resources available and the potential value of approaching health care challenges from different perspectives. The authors conducted an exploratory study to understand Canadian leaders' perceptions and experiences with both their own and the other domain, with the aim of increasing their understanding of the boundaries and opportunities for collaborative approaches to improving health care.

METHOD

The authors conducted this study in 2011-2012 using a qualitative interpretivist framework to guide the collection and analysis of data from semistructured interviews. They used criterion-based, maximum variation, and snowball sampling to select 15 leaders from the domains of QI/PS and CE to interview. They transcribed verbatim the interviews and coded the transcripts using a directed content analysis approach.

RESULTS

Participants described the relationship between QI/PS and CE in four ways: (1) the separation of QI/PS and CE as distinct interventions, (2) (re)positioning CE in QI/PS activities, (3) (re)positioning QI/PS in CE activities, and (4) further integrating QI/PS and CE.

CONCLUSIONS

These findings have important implications for how leaders in QI/PS and CE should mindfully and strategically negotiate their relationship to ensure the relevance and effectiveness of their domain's activities.

摘要

目的

质量改进/患者安全(QI/PS)和继续教育(CE)的努力目标是改善医疗保健结果。然而,它们之间很少有合作。鉴于可用资源有限以及从不同角度解决医疗保健挑战的潜在价值,这种缺乏整合可能会产生问题。作者进行了一项探索性研究,以了解加拿大领导人对自身和另一个领域的看法和经验,旨在增加他们对通过协作方法改善医疗保健的界限和机会的理解。

方法

作者在 2011 年至 2012 年期间使用定性解释主义框架来指导半结构化访谈中数据的收集和分析,以了解自身和另一个领域的看法和经验。他们使用基于标准、最大变化和滚雪球抽样的方法,从 QI/PS 和 CE 领域选择了 15 名领导人进行访谈。他们逐字转录了访谈内容,并使用定向内容分析方法对转录本进行了编码。

结果

参与者以四种方式描述了 QI/PS 和 CE 之间的关系:(1)将 QI/PS 和 CE 分开作为独立的干预措施,(2)将 CE 重新定位到 QI/PS 活动中,(3)将 QI/PS 重新定位到 CE 活动中,以及(4)进一步整合 QI/PS 和 CE。

结论

这些发现对 QI/PS 和 CE 领域的领导者如何谨慎而战略性地协商他们的关系以确保其活动的相关性和有效性具有重要意义。

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