Kania-Richmond Ania, Hetherington Erin, McNeil Deborah, Bayrampour Hamideh, Tough Suzanne, Metcalfe Amy
Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Matern Child Health J. 2017 Jun;21(6):1327-1335. doi: 10.1007/s10995-016-2236-1.
Objectives Introducing new programming into an existing setting may be challenging. Understanding how staff and clinicians who are not directly involved in program delivery view the program can help support program implementation. This study aimed to understand how peripheral staff and clinicians perceived a newly implemented Centering Pregnancy group prenatal care program in a community-based health center and its impact on clinic operations. Methods Semi-structured interviews were conducted with a purposive sample of 12 staff members at a community-based health center. The interview guide covered topics such as perceptions of Centering Pregnancy and how the program impacted their work. An interpretive description approach was used to analyze the interview data. A coding framework was developed iteratively and all interview data were analyzed independently by multiple researchers. Results Staff had overall positive perceptions of Centering Pregnancy, but the level of understanding about the program varied widely. Most respondents viewed the Centering Pregnancy program as separate from other programs offered by the clinic, which created both opportunities and challenges. Opportunities included increased cross-referrals between established services and Centering Pregnancy. Challenges included a lack of communication about responsibilities of staff in relation to Centering Pregnancy patients. Impact on staff and overall clinic operations was perceived to be minimal to moderate, and most tensions related to roles and expectations were resolved. Conclusions for Practice Clear communication regarding fit within clinic structures and processes and expectations of staff in relation to the program was critical to the integration of Centering Pregnancy program into an established health center.
目标 将新的项目引入现有的环境可能具有挑战性。了解未直接参与项目实施的工作人员和临床医生如何看待该项目有助于支持项目的实施。本研究旨在了解基层工作人员和临床医生如何看待在一家社区卫生中心新实施的“孕期集中护理”小组产前护理项目及其对诊所运营的影响。方法 对一家社区卫生中心的12名工作人员进行了有目的抽样的半结构式访谈。访谈指南涵盖了对“孕期集中护理”的看法以及该项目如何影响他们的工作等主题。采用解释性描述方法分析访谈数据。迭代开发了一个编码框架，所有访谈数据由多名研究人员独立分析。结果 工作人员对“孕期集中护理”总体上持积极看法，但对该项目的理解程度差异很大。大多数受访者认为“孕期集中护理”项目与诊所提供的其他项目不同，这既带来了机遇也带来了挑战。机遇包括现有服务与“孕期集中护理”之间转诊增加。挑战包括缺乏关于工作人员对“孕期集中护理”患者责任的沟通。对工作人员和诊所整体运营的影响被认为是最小到中等程度，并且大多数与角色和期望相关的紧张关系得到了解决。实践结论 关于在诊所结构和流程中的适应性以及工作人员对该项目的期望进行清晰沟通，对于将“孕期集中护理”项目融入既定的健康中心至关重要。
