Lacasta Tintorer David, Manresa Domínguez Josep Maria, Pujol-Rivera Enriqueta, Flayeh Beneyto Souhel, Mundet Tuduri Xavier, Saigí-Rubió Francesc
Centre d'Atenció Primària Gran Sol, Gerència d'Àmbit d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Avinguda del Doctor Bassols, 112 - 130, 08914, Badalona, Spain.
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol. CAP El Maresme, Camí del Mig, 36 planta 4a, 08303, Mataró, Spain.
BMC Fam Pract. 2018 May 9;19(1):56. doi: 10.1186/s12875-018-0739-0.
The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was created. This tool enables PC and non-GP specialist care (SC) professionals to raise clinical cases for consultation and to share information. The objective of this article is to explore healthcare professionals' views on communities of clinical practice (CoCPs) and the changes that need to be made in an uncontrolled real-life setting after more than two years of use.
A descriptive-interpretative qualitative study was conducted on a total of 29 healthcare professionals who were users and non-users of a CoCP using 2 focus groups, 3 triangular groups and 5 individual interviews. There were 18 women, 21 physicians and 8 nurses. Of the interviewees, 21 were PC professionals, 24 were users of a CoCP and 7 held managerial positions.
For a system of communication between PC and SC to become a tool that is habitually used and very useful, the interviewees considered that it would have to be able to find quick, effective solutions to the queries raised, based on up-to-date information that is directly applicable to daily clinical practice. Contact should be virtual - and probably collaborative - via a platform integrated into their habitual workstations and led by PC professionals. Organisational changes should be implemented to enable users to have more time in their working day to spend on the tool, and professionals should have a proactive attitude in order to make the most if its potential. It is also important to make certain technological changes, basically aimed at improving the tool's accessibility, by integrating it into habitual clinical workstations.
The collaborative tool that provides reliable, up-to-date information that is highly transferrable to clinical practice is valued for its effectiveness, efficiency and educational capacity. In order to make the most of its potential in terms of care and education, organisational changes and techniques are required to foster greater use.
基层医疗（PC）的当前现实情况使得必须具备远程医疗系统，以促进不同医疗层级之间的沟通。实践社区在医疗和教育方面具有巨大潜力，这就是创建基层与医院医疗在线沟通工具的原因。该工具使基层医疗和非全科医生专科医疗（SC）专业人员能够提出临床病例以供咨询并共享信息。本文的目的是探讨医疗保健专业人员对临床实践社区（CoCPs）的看法，以及在两年多的使用后，在不受控制的现实环境中需要做出的改变。
对总共29名医疗保健专业人员进行了一项描述性 - 解释性定性研究，这些人员是一个CoCP的使用者和非使用者，采用了2个焦点小组、3个三角小组和5次个人访谈。其中有18名女性，21名医生和8名护士。在受访者中，21名是基层医疗专业人员，24名是CoCP的使用者，7名担任管理职位。
对于基层医疗和专科医疗之间的沟通系统要成为一种经常使用且非常有用的工具，受访者认为它必须能够根据直接适用于日常临床实践的最新信息，快速、有效地解决提出的问题。沟通应该通过集成到他们日常工作站中的平台进行虚拟（可能是协作式）沟通，并由基层医疗专业人员主导。应实施组织变革，以便用户在工作日有更多时间使用该工具，并且专业人员应采取积极主动的态度，以充分发挥其潜力。进行某些技术变革也很重要，主要目的是通过将其集成到日常临床工作站中来提高工具的可及性。
提供可靠、最新且高度可转化为临床实践信息的协作工具，因其有效性、效率和教育能力而受到重视。为了在医疗和教育方面充分发挥其潜力，需要进行组织变革和采用相关技术以促进更多的使用。
