Myers Bronwyn, Williams Petal Petersen, Johnson Kim, Govender Rajen, Manderscheid Ron, Koch J Randy
Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2016 Feb 22;106(3):308-11. doi: 10.7196/SAMJ.2016.v106i3.9969.
In South Africa, concerns exist about the quality of substance abuse treatment. We developed a performance measurement system, known as the Service Quality Measures (SQM) initiative, to monitor the quality of treatment and assess efforts to improve quality of care. In 2014, the SQM system was implemented at six treatment sites to evaluate how implementation protocols could be improved in preparation for wider roll-out.
To describe providers' perceptions of the feasibility and acceptability of implementing the SQM system, including barriers to and facilitators of implementation.
We conducted 15 in-depth interviews (IDIs) with treatment providers from six treatment sites (two sites in KwaZulu-Natal and four in the Western Cape). Providers were asked about their experiences in implementing the system, the perceived feasibility of the system, and barriers to implementation. All IDIs were audio-recorded and transcribed verbatim. A framework approach was used to analyse the data.
Providers reported that the SQM system was feasible to implement and acceptable to patients and providers. Issues identified through the IDIs included a perceived lack of clarity about sequencing of key elements in the implementation of the SQM system, questions on integration of the system into clinical care pathways, difficulties in tracking patients through the system, and concerns about maximising patient participation in the process.
Findings suggest that the SQM system is feasible to implement and acceptable to providers, but that some refinements to the implementation protocols are needed to maximise patient participation and the likelihood of sustained implementation.
在南非，人们对药物滥用治疗的质量存在担忧。我们开发了一种绩效衡量系统，即服务质量衡量（SQM）倡议，以监测治疗质量并评估提高护理质量的努力。2014年，SQM系统在六个治疗地点实施，以评估如何改进实施协议，为更广泛的推广做准备。
描述提供者对实施SQM系统的可行性和可接受性的看法，包括实施的障碍和促进因素。
我们对来自六个治疗地点（夸祖鲁-纳塔尔省的两个地点和西开普省的四个地点）的治疗提供者进行了15次深入访谈（IDI）。询问提供者他们在实施该系统方面的经验、该系统的感知可行性以及实施的障碍。所有IDI都进行了录音并逐字转录。采用框架方法分析数据。
提供者报告说，SQM系统实施起来是可行的，患者和提供者都可以接受。通过IDI确定的问题包括在实施SQM系统时关键要素的顺序缺乏清晰度、关于将该系统整合到临床护理路径中的问题、通过该系统跟踪患者的困难以及对最大限度地提高患者参与该过程的担忧。
研究结果表明，SQM系统实施起来是可行的，提供者也可以接受，但需要对实施协议进行一些改进，以最大限度地提高患者参与度和持续实施的可能性。
