François P, Cardaci C, Lopez-Ruiz C, Boussat B, Marchand O
Unité d'évaluation médicale, pôle de santé publique, CHU de Grenoble, pavillon Taillefer, 38700 La Tronche, France.
Département de médecine générale, faculté de médecine, université de Grenoble-Alpes, 38700 La Tronche, France.
Rev Epidemiol Sante Publique. 2017 Feb;65(1):61-69. doi: 10.1016/j.respe.2016.08.004. Epub 2017 Jan 12.
Multiprofessionnal teams in primary care are developing in many countries including France. These groups appear very heterogeneous regarding the level of integration and interprofessional cooperation. A systematic review of the literature was performed to screen the instruments which assess the organizational development of primary care groups.
Scientific literature was searched in the Pubmed database, gray literature was searched for on the Internet. The documents were selected by two independent investigators. The collected data included information on assessment instruments: origin, content, method of use, and validation process.
Sixty-five documents involving 16 assessment instruments were selected for the study. Twelve instruments have been developed in North America and 4 in Europe. Four instruments were evaluation questionnaires, 4 accreditation tools and 8 were maturity matrices. The maturity matrices were structured by levels of organizational development. Their use were effected by an individual self-assessment of each professional and then by consensus of the group in the presence of an external facilitator. The questionnaire and accreditation tools have organizations and use patterns variable. The number of questions ranged from 25 to 200 with a median of 80. The instruments were organized into 4 to 16 dimensions with a median of 7. Six common themes were identified: practice and staff management, quality development, data patient management, interprofessional cooperation, accessibility and continuity of care, and formation. The validation process of tools were variable and often incomplete.
The set of assessment tools for primary care group is heterogeneous in purpose, content and mode of use. However, common themes were found for all tools. An evaluation questionnaire, in French, would be useful to monitor over time and evaluate the organizational development of centers and health houses in France.
包括法国在内的许多国家,基层医疗中的多专业团队正在不断发展。这些团队在整合水平和跨专业合作方面表现出很大的差异。我们进行了一项系统的文献综述,以筛选评估基层医疗团队组织发展的工具。
在PubMed数据库中检索科学文献,并在互联网上搜索灰色文献。由两名独立的研究人员选择文献。收集的数据包括评估工具的信息:来源、内容、使用方法和验证过程。
本研究共筛选出65篇涉及16种评估工具的文献。其中12种工具是在北美开发的,4种在欧洲开发。4种工具是评估问卷,4种是认证工具,8种是成熟度矩阵。成熟度矩阵按组织发展水平构建。其使用方法是先由每个专业人员进行个人自我评估,然后在外部协调人的参与下由团队达成共识。问卷和认证工具的组织和使用模式各不相同。问题数量从25个到200个不等,中位数为80个。这些工具分为4至16个维度,中位数为7个。确定了六个共同主题:实践与人员管理、质量发展、数据患者管理、跨专业合作、医疗服务的可及性与连续性以及培训。工具的验证过程各不相同,且往往不完整。
基层医疗团队的评估工具集在目的、内容和使用方式上存在差异。然而,所有工具都有共同的主题。一份法语评估问卷对于长期监测和评估法国的中心和健康之家的组织发展将是有用的。