Benzer Justin K, Mohr David C, Evans Leigh, Young Gary, Meterko Mark M, Moore Scott C, Nealon Seibert Marjorie, Osatuke Katerine, Stolzmann Kelly L, White Bert, Charns Martin P
VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, MA, USA Boston University School of Public Health, Boston, MA, USA VISN 17 Center of Excellence for Research on Returning War Veterans, TX, USA
VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, Boston, MA, USA Boston University School of Public Health, Boston, MA, USA.
Med Care Res Rev. 2016 Oct;73(5):565-89. doi: 10.1177/1077558715617380. Epub 2015 Dec 15.
Conceptual frameworks in health care do not address mechanisms whereby teamwork processes affect quality of care. We seek to fill this gap by applying a framework of teamwork processes to compare different patterns of primary care performance over time. We thematically analyzed 114 primary care staff interviews across 17 primary care clinics. We purposefully selected clinics using diabetes quality of care over 3 years using four categories: consistently high, improving, worsening, and consistently low. Analyses compared participant responses within and between performance categories. Differences were observed among performance categories for action processes (monitoring progress and coordination), transition processes (goal specification and strategy formulation), and interpersonal processes (conflict management and affect management). Analyses also revealed emergent concepts related to psychological and organizational context that were reported to affect team processes. This study is a first step toward a comprehensive model of how teamwork processes might affect quality of care.
医疗保健领域的概念框架并未涉及团队协作过程影响医疗质量的机制。我们试图通过应用一个团队协作过程框架来填补这一空白，以比较不同模式的初级保健绩效随时间的变化情况。我们对来自17家初级保健诊所的114名初级保健工作人员的访谈进行了主题分析。我们根据三年来糖尿病护理质量，有目的地选择了四类诊所：持续高、改善、恶化和持续低。分析比较了绩效类别内部和之间参与者的回答。在行动过程（监测进展和协调）、过渡过程（目标设定和战略制定）和人际过程（冲突管理和情感管理）的绩效类别之间观察到了差异。分析还揭示了与心理和组织背景相关的新出现的概念，据报告这些概念会影响团队过程。这项研究是朝着建立一个关于团队协作过程如何影响医疗质量的综合模型迈出的第一步。
