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与医院志愿者合作开展的以患者为中心的患者安全干预的定性形成性评价。

A qualitative formative evaluation of a patient-centred patient safety intervention delivered in collaboration with hospital volunteers.

机构信息

Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.

Leeds Institute of Medical Education, University of Leeds, Leeds, UK.

出版信息

Health Expect. 2017 Oct;20(5):1143-1153. doi: 10.1111/hex.12560. Epub 2017 Jun 15.

Abstract

BACKGROUND

Evidence suggests that patients can meaningfully feed back to healthcare providers about the safety of their care. The PRASE (Patient Reporting and Action for a Safe Environment) intervention provides a way to systematically collect feedback from patients to support service improvement. The intervention is being implemented in acute care settings with patient feedback collected by hospital volunteers for the first time.

OBJECTIVE

To undertake a formative evaluation which explores the feasibility and acceptability of the PRASE intervention delivered in collaboration with hospital volunteers from the perspectives of key stakeholders.

DESIGN

A qualitative evaluation design was adopted across two acute NHS trusts in the UK between July 2014 and November 2015. We conducted five focus groups with hospital volunteers (n=15), voluntary services and patient experience staff (n=3) and semi-structured interviews with ward staff (n=5). Data were interpreted using framework analysis.

RESULTS

All stakeholders were positive about the PRASE intervention as a way to support service improvement, and the benefits of involving volunteers. Volunteers felt adequate training and support would be essential for retention. Staff concentrated on the infrastructure needed for implementation and raised concerns around sustainability. Findings were fed back to the implementation team to support revisions to the intervention moving into the subsequent summative evaluation phase.

CONCLUSION

Although there are concerns regarding sustainability in practice, the PRASE intervention delivered in collaboration with hospital volunteers is a promising approach to collect patient feedback for service improvement.

摘要

背景

有证据表明,患者可以就其护理安全向医疗保健提供者提供有意义的反馈。PRASE(患者报告和行动以确保安全环境)干预措施提供了一种系统地收集患者反馈以支持服务改进的方法。该干预措施首次在急症护理环境中与医院志愿者合作实施,通过医院志愿者收集患者反馈。

目的

从主要利益相关者的角度,对与医院志愿者合作实施的 PRASE 干预措施的可行性和可接受性进行探索性评估。

设计

2014 年 7 月至 2015 年 11 月,在英国的两家 NHS 信托机构中采用了定性评估设计。我们进行了五次焦点小组讨论(n=15),参与者为医院志愿者;三次半结构化访谈(n=3),参与者为志愿部门和患者体验工作人员;以及五次半结构化访谈(n=5),参与者为病房工作人员。采用框架分析法对数据进行解释。

结果

所有利益相关者都对 PRASE 干预措施作为支持服务改进的一种方式以及涉及志愿者的好处表示肯定。志愿者认为适当的培训和支持对于保留志愿者至关重要。工作人员专注于实施所需的基础设施,并对可持续性表示担忧。研究结果反馈给实施团队,以支持在随后的总结性评估阶段对干预措施进行修订。

结论

尽管在实践中存在可持续性方面的担忧,但与医院志愿者合作实施的 PRASE 干预措施是一种有前途的方法,可以收集患者反馈以改善服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daf1/5600221/1206964dee86/HEX-20-1143-g001.jpg

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