Sockalingam Sanjeev, Tehrani Hedieh, Lin Elizabeth, Lieff Susan, Harris Ilene, Soklaridis Sophie
S. Sockalingam is deputy psychiatrist-in-chief, Toronto General and Princess Margaret sites, University Health Network, director of continuing professional and practice development, and associate professor, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. H. Tehrani is research assistant, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. E. Lin is associate professor, Department of Psychiatry, University of Toronto Faculty of Medicine, and adjunct scientist, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. S. Lieff is vice chair of education and professor, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. I. Harris is professor and head and director of graduate studies in health professions education leadership, Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois. S. Soklaridis is education scientist, Centre for Addiction and Mental Health, and assistant professor and head of research, innovation, and scholarship in education, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Acad Med. 2016 Apr;91(4):540-7. doi: 10.1097/ACM.0000000000000941.
To explore the perspectives of leaders in psychiatry and continuing professional development (CPD) regarding the relationship, opportunities, and challenges in integrating quality improvement (QI) and CPD.
In 2013-2014, the authors interviewed 18 participants in Canada: 10 psychiatrists-in-chief, 6 CPD leaders in psychiatry, and 2 individuals with experience integrating these domains in psychiatry who were identified through snowball sampling. Questions were designed to identify participants' perspectives about the definition, relationship, and integration of QI and CPD in psychiatry. Interviews were recorded and transcribed. An iterative, inductive method was used to thematically analyze the transcripts. To ensure the rigor of the analysis, the authors performed member checking and sampling until theoretical saturation was achieved.
Participants defined QI as a concept measured at the individual, hospital, and health care system levels and CPD as a concept measured predominantly at the individual and hospital levels. Four themes related to the relationship between QI and CPD were identified: challenges with QI training, adoption of QI into the mental health care system, implementation of QI in CPD, and practice improvement outcomes. Despite participants describing QI and CPD as mutually beneficial, they expressed uncertainty about the appropriateness of aligning these domains within a mental health care context because of the identified challenges.
This study identified challenges with aligning QI and CPD in psychiatry and yielded a framework to inform future integration efforts. Further research is needed to determine the generalizability of this framework to other specialties and health care professions.
探讨精神病学领域领导者以及继续职业发展（CPD）方面的专业人士对于整合质量改进（QI）与CPD之间的关系、机遇及挑战的看法。
2013年至2014年期间，作者在加拿大采访了18名参与者：10名首席精神病医生、6名精神病学领域的CPD领导者以及2名通过滚雪球抽样法确定的在精神病学领域有整合这些领域经验的个人。所提问题旨在明确参与者对于QI与CPD在精神病学中的定义、关系及整合的看法。访谈进行了录音及转录。采用迭代归纳法对转录文本进行主题分析。为确保分析的严谨性，作者进行了成员核对及抽样，直至达到理论饱和。
参与者将QI定义为一个在个体、医院及医疗保健系统层面进行衡量的概念，将CPD定义为一个主要在个体和医院层面进行衡量的概念。确定了与QI和CPD之间关系相关的四个主题：QI培训的挑战、将QI引入精神卫生保健系统、在CPD中实施QI以及实践改进成果。尽管参与者将QI和CPD描述为互利的，但由于已识别出的挑战，他们对在精神卫生保健背景下整合这些领域的适宜性表示不确定。
本研究确定了在精神病学中整合QI和CPD所面临的挑战，并产生了一个可为未来整合工作提供参考的框架。需要进一步研究以确定该框架对其他专业及医疗保健职业的可推广性。
