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“没有患者参与,我们如何谈论以患者为中心的医疗?” 从患者咨询委员会获得的经验教训。

"How Can We Talk about Patient-centered Care without Patients at the Table?" Lessons Learned from Patient Advisory Councils.

作者信息

Sharma Anjana E, Willard-Grace Rachel, Willis Andrew, Zieve Olivia, Dubé Kate, Parker Charla, Potter Michael B

机构信息

From the Department of Family & Community Medicine, University of California, San Francisco, School of Medicine (AES, RW-G, AW, OZ, KD, MBP); California Primary Care Association, Sacramento, CA (CP).

出版信息

J Am Board Fam Med. 2016 Nov 12;29(6):775-784. doi: 10.3122/jabfm.2016.06.150380.

Abstract

CONTEXT AND OBJECTIVE

Patient advisory councils (PACs) are a strategy for primary care clinics to engage patients in practice improvement. However, there is scant research on how PACs function. This study aimed to understand how PACs are organized and identify common challenges and perceived benefits of high-functioning PACs.

SETTING AND POPULATION

Key informants identified 8 primary care clinics in California with high-functioning PACs. Leaders from each of the 8 clinics nominated 1 clinic staff member and 1 PAC patient member to be interviewed.

STUDY DESIGN

Semistructured, one-on-one interviews were conducted at each clinic site or by phone. Interviews were dual-coded using modified grounded theory. Common themes were identified that would be pertinent to the development of future best practices for running PACs.

RESULTS

Common characteristics of high-functioning PACs included careful attention to participant recruitment, facilitation strategies guiding diverse personalities toward a common purpose, and assigning accountability for practice improvement projects. Interviewees identified a variety of positive outcomes that ranged from tangible improvements to the waiting area to a more patient-centered staff culture.

CONCLUSIONS

PACs show potential for promoting patient-centered practice improvements in primary care. Lessons learned from high-functioning PACs can inform a common set of strategies to assist practices in creating and sustaining effective advisory councils.

摘要

背景与目的

患者咨询委员会(PACs)是基层医疗诊所让患者参与实践改进的一种策略。然而,关于PACs如何运作的研究却很少。本研究旨在了解PACs是如何组织的,并确定高效PACs的常见挑战和感知到的益处。

设置与人群

关键信息提供者确定了加利福尼亚州8家拥有高效PACs的基层医疗诊所。8家诊所的负责人分别提名1名诊所工作人员和1名PAC患者成员接受访谈。

研究设计

在每个诊所现场或通过电话进行半结构化一对一访谈。访谈采用改良的扎根理论进行双重编码。确定了与未来运行PACs的最佳实践发展相关的共同主题。

结果

高效PACs的共同特征包括认真关注参与者招募、引导不同性格的人朝着共同目标前进的促进策略,以及为实践改进项目分配责任。受访者确定了各种积极成果,从候诊区的切实改善到更以患者为中心的员工文化。

结论

PACs在促进基层医疗中以患者为中心的实践改进方面显示出潜力。从高效PACs中学到的经验教训可为一套通用策略提供参考,以帮助各实践建立和维持有效的咨询委员会。

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