Newby Katie V, Parsons Joanne, Brooks Jessica, Leslie Rachael, Inglis Nadia
Centre for Technology Enabled Health Research (CTEHR), Faculty of Health and Life Sciences, Coventry University, Coventry and
Centre for Technology Enabled Health Research (CTEHR), Faculty of Health and Life Sciences, Coventry University, Coventry and.
Fam Pract. 2016 Jun;33(3):318-23. doi: 10.1093/fampra/cmw016. Epub 2016 Mar 28.
Influenza (flu) is an acute viral infection of the respiratory tract, which can lead to serious complications for individuals within at-risk groups. Evidence indicates that aspects of organization and delivery within GP practices can have an influence on the rates of flu vaccination uptake. Positive deviance is a methodological approach that facilitates identification of factors associated with high performance.
To use positive deviance to isolate factors associated with high performance by comparing GP practices achieving high and low flu vaccination uptake.
This was a qualitative study. A total of 18 practice managers and 2 GPs from 20 GP practices participated, 10 with high and low vaccination rates, respectively. Telephone interviews were conducted, audio recorded and fully transcribed. Framework Analysis was used to analyse the data.
High uptake practices were more likely than low uptake practices to have a lead member of staff who demonstrated tenacity, have aspirational uptake targets, have developed and used additional prompts within their IT systems to identify eligible patients, have GPs who were opportunistically vaccinating and use phone calls as a first-line strategy to invite patients for vaccination.
This is the first known qualitative study to identify strategies used by UK GP practices to deliver seasonal flu vaccination programmes. It is one of few studies using the robust and novel approach of positive deviance to inform health care recommendations. This approach has offered new and more nuanced insights into GP practice factors associated high flu vaccination uptake beyond those captured through large-scale survey research.
流感是一种急性呼吸道病毒感染，可导致高危人群出现严重并发症。有证据表明，全科医生诊所的组织和服务提供方面会对流感疫苗接种率产生影响。正向偏差是一种有助于识别与高绩效相关因素的方法。
通过比较流感疫苗接种率高和低的全科医生诊所，利用正向偏差来分离与高绩效相关的因素。
这是一项定性研究。来自20家全科医生诊所的18名诊所经理和2名全科医生参与其中，分别有10家接种率高和低的诊所。进行了电话访谈，录音并全文转录。采用框架分析法对数据进行分析。
与接种率低的诊所相比，接种率高的诊所更有可能有一名表现出坚韧不拔精神的主要工作人员，有抱负的接种目标，在其信息技术系统中开发并使用额外的提示来识别符合条件的患者，有机会性接种的全科医生，并将电话作为邀请患者接种疫苗的一线策略。
这是已知的第一项定性研究，旨在确定英国全科医生诊所实施季节性流感疫苗接种计划所采用的策略。这是少数几项使用正向偏差这一稳健且新颖的方法为医疗保健建议提供信息的研究之一。这种方法为与高流感疫苗接种率相关的全科医生诊所因素提供了新的、更细致入微的见解，这些见解超出了大规模调查研究所能获取的范围。
