Plymouth University, Peninsula Schools of Medicine and Dentistry, NIHR CLAHRC, South West Peninsula (PenCLAHRC), Plymouth, UK.
Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.
Health Expect. 2018 Apr;21(2):448-456. doi: 10.1111/hex.12631. Epub 2017 Nov 15.
Person Centred Coordinated Care (P3C) is a UK priority for patients, carers, professionals, commissioners and policy makers. Services are developing a range of approaches to deliver this care with a lack of tools to guide implementation.
A scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C. These were validated through codesign with stakeholders via a series of workshops and cognitive interviews.
Six core domains of P3C were identified as follows: (i) my goals, (ii) care planning, (iii) transitions, (iv) decision making (v), information and communication and (vi) organizational support activities. These were populated by 29 core subdomains (question items). A number of response codes (components) to each question provide examples of the processes and activities that can be actioned to achieve each core subdomain of P3C.
The P3C-OCT provides a coherent approach to monitoring progress and supporting practice development towards P3C. It can be used to generate a shared understanding of the core domains of P3C at a service delivery level, and support reorganization of care for those with complex needs. The tool can reliably detect change over time, as demonstrated in a sample of 40 UK general practices. It is currently being used in four UK evaluations of new models of care and being further developed as a training tool for the delivery of P3C.
以患者、护理人员、专业人员、决策者为中心的协调护理（P3C）是英国的优先事项。服务机构正在开发一系列方法来提供这种护理，但缺乏指导实施的工具。
通过对当前政策、主要文献和英国国民保健制度指南进行广泛审查和批判性检查，并结合利益相关者的参与，确定了提供 P3C 所需的领域、子领域和组成活动（流程和行为）。通过一系列研讨会和认知访谈，与利益相关者共同进行了代码设计，对这些活动进行了验证。
确定了 P3C 的六个核心领域，如下所示：(i) 我的目标，(ii) 护理计划，(iii) 过渡，(iv) 决策，(v) 信息和沟通，(vi) 组织支持活动。这些领域由 29 个核心子领域（问题项目）组成。每个问题的许多响应代码（组件）提供了可以采取的行动过程和活动的示例，以实现 P3C 的每个核心子领域。
P3C-OCT 为监测进展和支持实践发展提供了一种连贯的方法。它可用于在服务提供层面上生成对 P3C 核心领域的共同理解，并支持为有复杂需求的人重新组织护理。该工具可以可靠地检测随时间的变化，这在 40 个英国普通实践样本中得到了证明。它目前正在英国对新的护理模式的四项评估中使用，并正在进一步开发作为提供 P3C 的培训工具。
