Martin Anne, Manley Kim
a England Centre for Practice Development, Faculty of Health and Wellbeing , Canterbury Christ Church University , Canterbury , UK.
J Interprof Care. 2018 Jan;32(1):41-51. doi: 10.1080/13561820.2017.1373080. Epub 2017 Oct 23.
Integration of health and social care forms part of health and social care policy in many countries worldwide in response to changing health and social care needs. The World Health Organization's appeal for systems to manage the global epidemiologic transition advocates for provision of care that crosses boundaries between primary, community, hospital, and social care. However, the focus on structural and process changes has not yielded the full benefit of expected advances in care delivery. Facilitating practice in the workplace is a widely recognised cornerstone for developments in the delivery of health and social care as collaborative and inclusive relationships enable frontline staff to develop effective workplace cultures that influence whether transformational change is achieved and maintained. Workplace facilitation embraces a number of different purposes which may not independently lead to better quality of care or improved patient outcomes. Holistic workplace facilitation of learning, development, and improvement supports the integration remit across health and social care systems and avoids duplication of effort and waste of valuable resources. To date, no standards to guide the quality and effectiveness of integrated facilitation have been published. This study aimed to identify key elements constitute standards for an integrated approach to facilitating work-based learning, development, improvement, inquiry, knowledge translation, and innovation in health and social care contexts using a three rounds Delphi survey of facilitation experts from 10 countries. Consensus about priority elements was determined in the final round, following an iteration process that involved modifications to validate content. The findings helped to identify key qualities and skills facilitators need to support interprofessional teams to flourish and optimise performance. Further research could evaluate the impact of skilled integrated facilitation on health and social care outcomes and the well-being of frontline interprofessional teams.
整合健康与社会照护是全球许多国家健康与社会照护政策的一部分,以应对不断变化的健康与社会照护需求。世界卫生组织呼吁建立管理全球流行病学转变的系统,主张提供跨越初级、社区、医院和社会照护界限的照护。然而,对结构和流程变革的关注并未带来预期的照护提供方面进步的全部益处。促进工作场所的实践是健康与社会照护服务发展中广泛认可的基石,因为协作和包容的关系能使一线工作人员形成有效的工作场所文化,从而影响变革性变化能否实现并维持。工作场所促进包含许多不同目的,这些目的可能无法独立带来更高的照护质量或改善患者结局。全面的工作场所学习、发展与改进促进支持了健康与社会照护系统的整合任务,避免了工作的重复和宝贵资源的浪费。迄今为止,尚未发布指导综合促进质量和有效性的标准。本研究旨在通过对来自10个国家的促进专家进行三轮德尔菲调查,确定构成在健康与社会照护背景下促进基于工作的学习、发展、改进、探究、知识转化和创新的综合方法标准的关键要素。在经过一轮涉及内容验证修改的迭代过程后,在最后一轮确定了关于优先要素的共识。研究结果有助于确定促进者支持跨专业团队蓬勃发展并优化绩效所需的关键素质和技能。进一步的研究可以评估熟练的综合促进对健康与社会照护结果以及一线跨专业团队福祉的影响。